SHM Converge Scientific Abstract ePoster Gallery-Ocular Syphilis: A Case Series

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This document summarizes a case series of ocular syphilis diagnosed at a military treatment facility from 2020–2021, while also reviewing the broader public health context. Syphilis is rising in the United States, with especially high rates among men who have sex with men and patients co-infected with HIV. Ocular syphilis is a relatively uncommon complication, estimated to occur in 0.6–2% of syphilis cases, but it can cause serious and potentially preventable vision loss. Because syphilis can mimic many eye diseases, diagnosis is often delayed.<br /><br />The report defines ocular syphilis as ocular disease in a person with laboratory-confirmed syphilis infection of any stage. Common manifestations include posterior uveitis and panuveitis, though presentations are variable. Diagnosis requires two positive serologic tests plus compatible ocular signs and symptoms; cerebrospinal fluid testing is not routinely required unless neurologic or cranial nerve symptoms are present.<br /><br />Five cases were identified. All patients had positive serum RPR and/or treponemal testing and presented with symptoms such as floaters, blurred vision, or central vision loss. Ophthalmologic diagnoses included bilateral uveitis, panuveitis, neuroretinitis, iridocyclitis, and chorioretinitis/choroiditis. The average delay from symptom onset to diagnosis was 88 days, and the average delay from first medical visit to diagnosis was 52 days, highlighting frequent missed opportunities for earlier recognition. One patient was newly diagnosed with HIV at the time of syphilis diagnosis.<br /><br />Treatment consists of IV penicillin for 10–14 days, with follow-up non-treponemal testing such as RPR to confirm response. The authors emphasize that all ocular syphilis cases should be reported to local public health authorities within 24 hours.

Asset Subtitle

Michael Dore

Meta Tag

Author List Christa Kerbow, Karl Kronnman, Michael Dore, Michelle Kautz, Tida Lee

Category Clinical Vignettes

Concept Ocular Syphilis

Concept Syphilis

Concept Serologic Test

Concept Intravenous Penicillin G

Concept Posterior Uveitis

Distinguished Non-Finalist

Presenter Organization Durham Veterans Affairs Hospital

Presenting Author Michael Dore

Track Adult

Keywords

ocular syphilis

syphilis

uveitis

panuveitis

neuroretinitis

chorioretinitis

vision loss

RPR testing

HIV co-infection

public health reporting

Ocular Syphilis

Syphilis

Serologic Test

Intravenous Penicillin G

Posterior Uveitis