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[Ocular syphilis, a re-emergent pathology: Series of 12 patients in one Hospital, 2017].

Authors
  • Gutierrez, B1
  • Gayet, S2
  • Bertolino, J3
  • Jean, E3
  • Le Goff, L4
  • Voisin, H5
  • Sampo, M5
  • Meunier, B3
  • Harle, J-R3
  • Ebbo, M3
  • Schleinitz, N3
  • Menard, A6
  • Bernit, E3
  • 1 Service de medecine interne, CHU limoges, CHU de Limoges, 2, avenue Martin-Luther-King, 87000 Limoges, France. Electronic address: [email protected] , (France)
  • 2 Service de gériatrie, AP-HM, 278, rue Saint-Pierre, 13005 Marseille, France. , (France)
  • 3 Service de service de médecine interne, AP-HM, 278, rue Saint-Pierre, 13005 Marseille, France. , (France)
  • 4 8, allée Turcat-Mery, 13008 Marseille, France. , (France)
  • 5 Service d'ophtalmologie, AP-HM, 278, rue Saint-Pierre, 13005 Marseille, France. , (France)
  • 6 Service de maladies infectieuses et tropicales de l'IHU méditerranée infection, 19-21, boulevard Jean-Moulin, 13005 Marseille, France. , (France)
Type
Published Article
Journal
La Revue de medecine interne
Publication Date
Mar 01, 2020
Volume
41
Issue
3
Pages
160–167
Identifiers
DOI: 10.1016/j.revmed.2019.06.006
PMID: 31301942
Source
Medline
Language
French
License
Unknown

Abstract

Syphilis is a sexually transmitted disease. All organs might be affected, but ocular syphilis only occurs in 0.6 percent of patients. We collected all cases of ocular syphilis requiring hospitalization at the University Hospital Center (UHC) in Marseille in 2017. This was a retrospective monocentric study. The diagnosis of ocular syphilis was based on the combination of ocular inflammation with a positive syphilitic serology. For each patient, sex, age, HIV status, ocular and extraocular symptoms, initial visual acuity, syphilis serology, cerebrospinal fluid (CSF) analysis if done, treatment and clinical response were collected. Ten men and two women, aged 28 to 86 years, were hospitalized. Two patients were HIV-positive. Ophtalmological lesions were heterogeneous the posterior structures were most affected. Anterior uveitis was isolated in one patient. Five patients had extraocular signs with cutaneous and/or mucosal involvement. No patient had neurological symptoms. Diagnosis of neurosyphilis through CSF analysis was definite for one patient, probable for 5 patients and ruled out for 2 patients. Six patients received treatment with penicillin G and six with ceftriaxone. Visual acuity improved in all cases. Ophtalmic cases of syphilis have become more frequent over the past few years in France. The diagnosis should be suspected in cases of eye inflammation even in the absence of favourable clinical presentation or anamnesis. Search for HIV co-infection should be systematic. Our study shows that ceftriaxone remains an effective alternative to penicillin G. Copyright © 2019 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.

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