4.3 Letter

A Case of Syphilis with a Rare Finding: Subretinal Hypopyon

Journal

OCULAR IMMUNOLOGY AND INFLAMMATION
Volume 31, Issue 7, Pages 1315-1319

Publisher

TAYLOR & FRANCIS INC
DOI: 10.1080/09273948.2023.2168702

Keywords

Ocular syphilis; optic neuritis; retinitis; subretinal hypopyon; syphilis

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This study reports the clinical features and follow-up of a case with subretinal hypopyon due to syphilis infection. The patient, who was admitted with optic neuritis, was treated with intravenous pulse steroids without antibiotics. Subsequently, the patient was referred to the uvea clinic due to decreased vision and multiple retinitis foci. Subretinal hypopyon was diagnosed in the left eye, along with a positive TPHA test. Antibiotic therapy resulted in significant regression of retinitis and hypopyon.
Purpose To report clinical features and follow-up of a case with subretinal hypopyon due to syphilis infection.Case presentation We present a case of syphilis admitted with optic neuritis and treated with intravenous pulse steroids without antibiotics. The patient was referred to the uvea clinic in the follow-up because of decreased vision and the onset of multiple retinitis foci. We determined subretinal hypopyon in the left eye and a positive TPHA test. A significant regression was observed in retinitis and hypopyon with antibiotic therapy.Conclusion Before starting a steroid treatment, infective etiologies should be considered in patients with optic neuritis. Treating with a high dosage of steroids without antibiotics in syphilis would worsen the clinical features and prognosis.

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