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Purpose: To describe the appearance and resolution of a vascularized iris nodule in a case of ocular syphilis with swept-source anterior segment optical coherence tomography (SS AS-OCT) imaging.
Methods: Case report.
Results: A 73-year-old male with a history of ocular syphilis presented with anterior uveitis of the left eye characterized by mutton fat keratic precipitates, anterior chamber cells, hypopyon mixed with hemorrhage, and a vascularized iris nodule. SS AS-OCT similarly showed keratic precipitates, anterior chamber cells, and an iris lesion with anterior hyperreflectivity and shadowing. Systemic workup revealed a new syphilis infection with rapid plasma reagin (RPR) titer of 1:512. After completing a 14-day course of intravenous penicillin and topical steroid treatment, there was resolution of these ocular findings.
Conclusion: Ocular syphilis should be considered on the differential diagnosis for vascularized iris lesions. Our case demonstrates SS-AS-OCT findings in this rare presentation of ocular syphilis.
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http://dx.doi.org/10.1080/09273948.2025.2514693 | DOI Listing |
Ocul Immunol Inflamm
September 2025
Division of Ophthalmology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Purpose: To describe differences in the expression of selected host biomarkers, by analysing the aqueous humour (AH), cerebrospinal fluid (CSF) and serum of patients with ocular syphilis, both with and without neurosyphilis and HIV infection, to support the diagnosis of ocular syphilis.
Methods: A prospective observational descriptive study was conducted at Tygerberg Academic Hospital in Cape Town, South Africa, from February 1, 2018, to January 31, 2021. The study included all patients aged 18 years or older who presented to the eye clinic with ocular syphilis, provided they had a positive serum Treponema pallidum antibodies (TPA) test, an RPR titre of ≥ 8 and confirmed ocular inflammation.
Cureus
August 2025
Ophthalmology, Henry Ford Health System, Detroit, USA.
This report discusses a case of diagnosing neurosyphilis in a non-classical presentation with confounding test results needing a deliberate and multidisciplinary diagnostic approach. A 38-year-old immunocompetent male presented with uveitis and a skin rash. Although serology was positive for syphilis (rapid plasma reagin 1:128), it was also positive for tuberculosis, and a dermatology consult identified the rash as psoriasis, creating a complex diagnostic picture.
View Article and Find Full Text PDFBrain
September 2025
Department of Neurology, University of Washington, Seattle, WA, USA.
The incidence of syphilis has increased world-wide over the last ∼25 years, and this increase has been accompanied by a resurgence of neurosyphilis. This review sets the stage for understanding neurosyphilis by briefly summarizing the clinical and laboratory findings in uncomplicated syphilis. It then addresses the epidemiology, clinical manifestations, and treatment of neurosyphilis beginning with information from the pre-penicillin era and extending to modern studies.
View Article and Find Full Text PDFCureus
July 2025
Ophthalmology, University Hospital Southampton National Health Service (NHS) Foundation Trust, Southampton, GBR.
Aim: This case series seeks to share our experience with ocular syphilis by reporting the clinical findings and management of nine diagnosed cases.
Materials And Methods: This retrospective case series comprises nine patients who presented to the Ophthalmology Department of Southampton General Hospital between 2013 and 2022. The series provides a comprehensive report on patients diagnosed with ocular syphilis, detailing the severity of the condition, associated symptoms, and the treatments administered.
Eur J Ophthalmol
August 2025
Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
PurposeTo report a rare case of acute corneal hydrops and conjunctival ulceration secondary to acquired syphilis.MethodsA male in his late 30's presented with redness, pain, and watering in both eyes and sudden loss of vision in the left eye. Examination revealed bilateral conjunctival ulcers along with well-circumscribed corneal edema with blunt stunted intrinsic vessel in the left eye.
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