Simultaneous ocular and osseous syphilis: a case report

• Published in: Arquivos brasileiros de oftalmologia Vol. 85; no. 3
• Main Authors: Guimarães, Juliana Albano de, Paccola, Marcelo
• Format: Journal Article
• Language: English
• Published: Conselho Brasileiro de Oftalmologia 01-01-2022
• Subjects: OPHTHALMOLOGY; Infecções oculares bacterianas; Uveíte posterior; Coriorretinite; Periostite; Syphilis/complications; Chorioretinitis; Neurosyphilis; Periostitis; Case report; Relato de caso; Neurossífilis; Sífilis/complicações; Uveitis, posterior; Eye infections, bacterial
• ISSN: 0004-2749; 1678-2925
• DOI: 10.5935/0004-2749.20220043

ABSTRACT Syphilis is a reemerging and potentially serious disease. Owing to its ubiquity and pleomorphism, it is called “the great imitator”. We report the case of a young woman with secondary syphilis who presented with bilateral acute syphilitic posterior placoid chorioretinopathy along with a syphilitic skull periostitis. A pachymeningeal enhancement was observed on magnetic resonance imaging, but we believe it was an extension of the bone process rather than a meningitis itself on the basis of the normal cerebrospinal fluid analysis results. Treatment with intravenous crystalline penicillin resulted in complete resolution of the signs, symptoms, and imaging findings. Secondary syphilis is the stage with the highest bacteremia and the highest transmissibility, presenting mainly with mucocutaneous disorders and, less frequently, with involvement of other organs. High suspicion and a pragmatic approach are essential to the diagnosis because this disease can affect several organs, as in the present case, in which the eyes, bones, and skin were affected.