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Ocular perineuritis secondary to neurosyphilis.
Optom Vis Sci. 2010 Oct; 87(10):E790-6.OV

Abstract

BACKGROUND

Syphilis is a condition caused by the spirochete Treponema pallidum (T. pallidum). Because of its ubiquitous nature, it has been coined as "the great masquerader." Syphilis can present with a wide array of clinical symptoms and manifestations, making it difficult to diagnose. The spectrum of visual system manifestations is broad and involves the anterior and posterior segments. We report a rare case of ocular perineuritis in an HIV-positive patient with neurosyphilis.

CASE REPORT

A 33-year-old HIV-positive white male presented with blurred vision and floaters of 2 weeks duration. He reported coinciding neurological symptoms including headaches, nausea, and extreme weight loss. He also manifested an erythematous rash on his scalp. Fundoscopy revealed bilateral disc edema.

CONCLUSIONS

Syphilitic ocular perineuritis is a condition that manifests with swollen optic discs in the absence of raised intracranial pressure or visual disturbance. This condition is due to inflammation of the optic nerve sheath and is often mistaken for papilledema or papillitis. Optic perineuritis is an infrequently reported complication of syphilitic disease. Early diagnosis of neurosyphilis and its complications is critical, because it is easily treated with penicillin when initiated early on.

Authors+Show Affiliations

Midwestern University, Arizona College of Optometry, Glendale, Arizona 85038, USA. KellyMeehanOD@gmail.comNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

20802364

Citation

Meehan, Kelly, and Julie Rodman. "Ocular Perineuritis Secondary to Neurosyphilis." Optometry and Vision Science : Official Publication of the American Academy of Optometry, vol. 87, no. 10, 2010, pp. E790-6.
Meehan K, Rodman J. Ocular perineuritis secondary to neurosyphilis. Optom Vis Sci. 2010;87(10):E790-6.
Meehan, K., & Rodman, J. (2010). Ocular perineuritis secondary to neurosyphilis. Optometry and Vision Science : Official Publication of the American Academy of Optometry, 87(10), E790-6. https://doi.org/10.1097/OPX.0b013e3181f361b0
Meehan K, Rodman J. Ocular Perineuritis Secondary to Neurosyphilis. Optom Vis Sci. 2010;87(10):E790-6. PubMed PMID: 20802364.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ocular perineuritis secondary to neurosyphilis. AU - Meehan,Kelly, AU - Rodman,Julie, PY - 2010/8/31/entrez PY - 2010/8/31/pubmed PY - 2011/3/25/medline SP - E790 EP - 6 JF - Optometry and vision science : official publication of the American Academy of Optometry JO - Optom Vis Sci VL - 87 IS - 10 N2 - BACKGROUND: Syphilis is a condition caused by the spirochete Treponema pallidum (T. pallidum). Because of its ubiquitous nature, it has been coined as "the great masquerader." Syphilis can present with a wide array of clinical symptoms and manifestations, making it difficult to diagnose. The spectrum of visual system manifestations is broad and involves the anterior and posterior segments. We report a rare case of ocular perineuritis in an HIV-positive patient with neurosyphilis. CASE REPORT: A 33-year-old HIV-positive white male presented with blurred vision and floaters of 2 weeks duration. He reported coinciding neurological symptoms including headaches, nausea, and extreme weight loss. He also manifested an erythematous rash on his scalp. Fundoscopy revealed bilateral disc edema. CONCLUSIONS: Syphilitic ocular perineuritis is a condition that manifests with swollen optic discs in the absence of raised intracranial pressure or visual disturbance. This condition is due to inflammation of the optic nerve sheath and is often mistaken for papilledema or papillitis. Optic perineuritis is an infrequently reported complication of syphilitic disease. Early diagnosis of neurosyphilis and its complications is critical, because it is easily treated with penicillin when initiated early on. SN - 1538-9235 UR - https://www.unboundmedicine.com/medline/citation/20802364/Ocular_perineuritis_secondary_to_neurosyphilis_ L2 - https://doi.org/10.1097/OPX.0b013e3181f361b0 DB - PRIME DP - Unbound Medicine ER -