Neurosyphilis concurrently involving eye and ear

Description 

A 42-year-old woman presented to our hospital with a 2-month history of bilateral decreased and blurry vision accompanying mild photophobia. She had had several episodes of unsafe sex and was diagnosed with secondary syphilis 10 months prior. Despite the diagnosis, she did not undergo any treatment for the infection. An ophthalmological examination revealed bilateral macular oedema, suggesting the development of uveitis (figure 1A,B). Laboratory data for complete blood counts and chemistry were unremarkable, but there were elevations of rapid plasma reagin (RPR) test and Treponema pallidum haemagglutination test (TPHA) titres, at 1:32 and 1:5120, respectively, leading to the diagnosis of ocular syphilis. Screening tests for hepatitis B virus, hepatitis C virus and HIV yielded negative findings. Further cerebrospinal fluid examination indicated a complication of neurosyphilis, with a mildly elevated white cell count (0.013x10⁹/L), protein level (49 mg/dL), and positive RPR (1:4) and TPHA (1:320) titres. The...

https://ift.tt/2NTwEQR