On examination, the patient had a best-corrected visual acuity (VA) of 20/20 in each eye. His medications included tamsulosin, hydrochlorothiazide/losartan, aspirin 81mg, atorvastatin, and metoprolol. ![]() He was being evaluated for non-tuberculous mycobacterial lung infection with multiple lung nodules. His medical history was remarkable for hearing loss and tinnitus, coronary stent, hypertension, and non-alcoholic fatty liver. His past ocular history was remarkable for migraines with aura. He also noted redness in both eyes beginning three months prior to presentation. Case PresentationĪ 60-year-old male presented with complaints of blurred vision and black and white spots in the temporal field in both eyes. 2 In this paper, we present a case of a progressive bilateral granulomatous panuveitis secondary to syphilis. 3–5 All cases of syphilis must be reported to local departments of health (DOH), which aids in identifying, testing and treating all involved partners. 2 The Centers for Disease Control and Prevention (CDC) defines ocular syphilis as clinical symptoms or signs consistent with ocular disease with syphilis of any stage. 2 If it penetrates the blood-brain barrier, T. pallidum, causes local inflammatory reactions by traveling and replicating throughout the body. Treponema pallidum causes syphilis via direct sexual exposure, through the placenta during any gestational period, or through vertical transmission as the unborn child touches the maternal genital lesions in the birth canal. The COPE course test must be taken before the course expiry date. Please check COPE course expiry date prior to enrollment. Read the article and take the qualifying test to earn your credit. You may take this course for 1-hour credit. This article is available as a COPE accredited CE course. This case report underscores the importance of obtaining a detailed case history and taking a multi-disciplinary approach to patients with progressive uveitis. The patient was treated with intravenous penicillin with eventual resolution of his ocular inflammation. A diagnostic work-up in collaboration with the hospital infectious disease department led to a diagnosis of neurosyphilis. The patient’s clinical course improved until he tapered off the drops, upon which he presented with a progressive bilateral panuveitis. He was started on difluprednate emulsion four times a day in each eye. ![]() Case ReportĪ 60-year-old male with a three-month history of redness and floaters presented with bilateral chronic granulomatous anterior uveitis. To describe the management of a case of progressive uveitis secondary to syphilis. This report outlines a case of progressive bilateral granulomatous panuveitis secondary to syphilis.
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