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KMID : 1038920160150010025
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Annals of Optometry and Contact Lens
2016 Volume.15 No. 1 p.25 ~ p.27
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Episcleritis as a Manifestation of Ocular Syphilis
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박용석:Park Yong-Seok
이효석:Lee Hyo-Seok/최원:Choi Won/윤경철:Yoon Kyung-Chul
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Abstract
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Purpose: To report a rare case of episcleritis as the only manifestation of ocular syphilis.
Case summary: A 55-year-old male was referred to the outpatient clinic because of both episcleritis that was not improved after 3 weeks of treatment. Slit lamp examination showed tortuous congestion of engorged episcleral vessels with swelling in both eyes, but fundus and radiological studies showed normal findings. Serological tests were reactive for venereal disease research laboratory test, treponema pallidum hemagglutination assay test, and fluorescent treponemal antibody absorption test. Under the suspicion of persistent syphilis infection, cerebrospinal fluid (CSF) examination was performed, and there was no evidence of central nerve system infection of syphilis. Ocular syphilis with episcleritis was diagnosed. Treatment consisted of intravenous injections of 5 million international units (IU) penicillin G potassium every 4 hours for 10 days. The ocular inflammation resolved after 5 days of treatment and did not recur for 6 months.
Conclusions: Differential diagnosis of ocular syphilis with not only serological tests but also CSF test is important in a case of episcleritis not treated with conventional treatment. We report of a case that CSF examination shows negative results of syphilis treated well with experiential penicillin therapy.
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KEYWORD
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Scleritis, Sexually transmitted diseases, Syphilis, VDRL antigen
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