To review cases of ocular syphilis presenting to a tertiary uveitis clinic during a syphilis epidemic in France between January 2001 and January 2004.
Retrospective chart and patient database review.
Ten patients who presented with symptoms and signs of uveitis tested positive for active syphilis. Some of the patients also presented with a rash or headache. Human immunodeficiency virus (HIV) antibody testing was positive in eight of the 10 patients, with CD4 cell counts >200 cells/mm3 in seven of the patients. Ocular inflammation resolved and visual acuity improved in all patients after treatment.
A diagnosis of ocular syphilis should be considered in any patient with visual loss associated with a rash or headache, irrespective of the patient's CD4 cell count. Ocular syphilis in HIV-positive patients should be treated as neurosyphilis, whereas ocular syphilis in non-HIV patients can be treated as secondary syphilis.
A diagnosis of ocular syphilis should be considered whenever a patient with a rash and/or headache presents with visual loss. The treatment of ocular syphilis differs according to the HIV status of the patient.
From the *Department of Ophthalmology, Cochin Hospital, Paris V University, Paris, France; †Department of Ophthalmology, Mayo Clinic College of Medicine, Rochester, Minnesota; and ‡Department of Internal Medicine, Cochin Hospital, Paris V University, Paris, France
Correspondence: Christine Parc, Service d'Ophtalmologie, Hôpital Foch, 40 rue Worth-BP 36-92151 Suresnes Cedex-France. E-mail: email@example.com.
Received for publication June 23, 2006, and accepted November 2, 2006.