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Neurosyphilis Presenting as an Atypical Case of Posterior Placoid Chorioretinitis in a Young, HIV-Negative Male

Ocular syphilis can occur at any time after initial infection and most commonly presents as posterior uveitis or panuveitis, although many other ocular findings have been documented. We present the case of a young, otherwise healthy Caucasian HIV-negative male who presented with acute onset of photo...

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Autores principales: Bierowski, Matthew J, Wang, Rui, Javaid, Hafiza W, Amin, Neil, Popa, Alina L
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8447855/
https://www.ncbi.nlm.nih.gov/pubmed/34540495
http://dx.doi.org/10.7759/cureus.17274
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author Bierowski, Matthew J
Wang, Rui
Javaid, Hafiza W
Amin, Neil
Popa, Alina L
author_facet Bierowski, Matthew J
Wang, Rui
Javaid, Hafiza W
Amin, Neil
Popa, Alina L
author_sort Bierowski, Matthew J
collection PubMed
description Ocular syphilis can occur at any time after initial infection and most commonly presents as posterior uveitis or panuveitis, although many other ocular findings have been documented. We present the case of a young, otherwise healthy Caucasian HIV-negative male who presented with acute onset of photopsias, floaters, and a rapidly progressive unilateral scotoma who was originally diagnosed with acute zonal occult outer retinopathy (AZOOR) and started on a high dose prednisone taper. Although his clinical symptoms improved on corticosteroids, he was later switched to Penicillin G treatment when his blood and cerebrospinal fluid (CSF) testing demonstrated syphilis as his underlying diagnosis. Given his ocular findings on the exam and reactive syphilitic testing, he was ultimately diagnosed with acute syphilitic posterior placoid chorioretinitis (ASPPC). Our patient's clinical improvement after a high-dose prednisone trial offers further evidence of an autoimmune component to the pathophysiology of ASPPC.
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spelling pubmed-84478552021-09-17 Neurosyphilis Presenting as an Atypical Case of Posterior Placoid Chorioretinitis in a Young, HIV-Negative Male Bierowski, Matthew J Wang, Rui Javaid, Hafiza W Amin, Neil Popa, Alina L Cureus Ophthalmology Ocular syphilis can occur at any time after initial infection and most commonly presents as posterior uveitis or panuveitis, although many other ocular findings have been documented. We present the case of a young, otherwise healthy Caucasian HIV-negative male who presented with acute onset of photopsias, floaters, and a rapidly progressive unilateral scotoma who was originally diagnosed with acute zonal occult outer retinopathy (AZOOR) and started on a high dose prednisone taper. Although his clinical symptoms improved on corticosteroids, he was later switched to Penicillin G treatment when his blood and cerebrospinal fluid (CSF) testing demonstrated syphilis as his underlying diagnosis. Given his ocular findings on the exam and reactive syphilitic testing, he was ultimately diagnosed with acute syphilitic posterior placoid chorioretinitis (ASPPC). Our patient's clinical improvement after a high-dose prednisone trial offers further evidence of an autoimmune component to the pathophysiology of ASPPC. Cureus 2021-08-18 /pmc/articles/PMC8447855/ /pubmed/34540495 http://dx.doi.org/10.7759/cureus.17274 Text en Copyright © 2021, Bierowski et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Ophthalmology
Bierowski, Matthew J
Wang, Rui
Javaid, Hafiza W
Amin, Neil
Popa, Alina L
Neurosyphilis Presenting as an Atypical Case of Posterior Placoid Chorioretinitis in a Young, HIV-Negative Male
title Neurosyphilis Presenting as an Atypical Case of Posterior Placoid Chorioretinitis in a Young, HIV-Negative Male
title_full Neurosyphilis Presenting as an Atypical Case of Posterior Placoid Chorioretinitis in a Young, HIV-Negative Male
title_fullStr Neurosyphilis Presenting as an Atypical Case of Posterior Placoid Chorioretinitis in a Young, HIV-Negative Male
title_full_unstemmed Neurosyphilis Presenting as an Atypical Case of Posterior Placoid Chorioretinitis in a Young, HIV-Negative Male
title_short Neurosyphilis Presenting as an Atypical Case of Posterior Placoid Chorioretinitis in a Young, HIV-Negative Male
title_sort neurosyphilis presenting as an atypical case of posterior placoid chorioretinitis in a young, hiv-negative male
topic Ophthalmology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8447855/
https://www.ncbi.nlm.nih.gov/pubmed/34540495
http://dx.doi.org/10.7759/cureus.17274
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