PDF(Pubmed)
Abstract：
Syphilis is a bacterial disease caused by Treponema pallidum and is sexually transmitted via vaginal, anogenital, or orogenital contact. Vertical transmission between mother and unborn child is also possible, but transmission via skin-to-skin or blood contact is rare. The objective of this case is to highlight this rare ocular manifestation of syphilis as it manifests as a multisystemic disease affecting many organ systems. This is a case of a 46-year-old male with vision loss who was referred to the emergency department by an ophthalmologist. Two days before the presentation at the emergency department, the ophthalmologist observed the presence of optic disc edema in the left eye. At the emergency department, he complained of bright light spots in the left eye and complete darkness in the central aspect of the eyes. He reported having a non-pruritic erythematous rash on the anterior abdomen that began one week before his presentation at the emergency department. The patient also reported having multiple sexual partners. Physical examination findings showed a visual field defect in the left eye, normal bilateral eye movement, and a non-tender skin reticulation over the anterior abdominal wall. Lab results showed complete blood count (CBC) and comprehensive metabolic panel (CMP) within normal limits, fluorescent treponemal antibody (FTA) antibody reactive, human immunodeficiency virus (HIV) test and hepatitis panel negative, rapid plasma reagin (RPR) titer 1:64, and imaging results negative for any significant abnormalities. The infectious disease specialists were consulted, and the recommended IV penicillin of four million units every four hours was given. The patient reported an improvement in his blurry vision over three days. By six months, his vision was back to baseline. This case report is significant due to the rare occurrence of ocular complications as an initial presentation of syphilis. Considering the rising cases of syphilis in the United States, it is important to highlight the possibility of this uncommon clinical presentation of syphilis.
摘要：
梅毒是一种由梅毒螺旋体引起的细菌性疾病，通过阴道性传播，肛门生殖器,或生殖接触。母亲和未出生的孩子之间的垂直传播也是可能的，但是通过皮肤对皮肤或血液接触传播很少。这种情况的目的是强调梅毒的这种罕见眼部表现，因为它表现为影响许多器官系统的多系统疾病。这是一例46岁的男性视力丧失，由眼科医生转诊至急诊科。在急诊室的演讲前两天，眼科医生观察到左眼存在视盘水肿。在急诊室，他抱怨左眼有明亮的光点，眼睛中央面完全黑暗。他报告说，在急诊就诊前一周，前腹部出现了非瘙痒性红斑皮疹。患者还报告有多个性伴侣。体检结果显示左眼视野缺损,正常的双侧眼球运动，和前腹壁上的皮肤网状物。实验室结果显示全血细胞计数（CBC）和综合代谢组（CMP）在正常范围内，荧光螺旋体抗体（FTA）抗体反应性，人类免疫缺陷病毒（HIV）测试和肝炎面板阴性，快速血浆反应素（RPR）滴度为1:64，影像学结果对任何明显异常均为阴性。咨询了传染病专家，并建议每4小时静脉注射400万单位的青霉素。患者报告在三天内视力模糊有所改善。六个月前,他的视力回到了基线。由于很少发生眼部并发症作为梅毒的初始表现，因此该病例报告具有重要意义。考虑到美国梅毒病例的增加，重要的是要强调这种罕见的梅毒临床表现的可能性。
