Acute Syphilitic Posterior Placoid Chorioretinitis Misdiagnosed as Systemic Lupus Erythematosus Associated Uveitis

ABSTRACT

Purpose: The authors report a case of a systemic lupus erythematosus (SLE) patient who suffered rapid loss of vision after being misdiagnosed as SLE associated uveitis and treated with glucocorticoid. She was eventually diagnosed with acute syphilitic posterior placoid chorioretinitis (ASPPC) after further serological inspection and detailed ophthalmic examination, and gained improved visual acuity through massive penicillin G treatment.

Methods: Retrospective review of a case note.

Conclusions: Concealment of syphilis history and absence of serological examination, coupled with its rarity, can make the diagnosis of ASPPC extremely difficult, especially when combined with simultaneous systemic or immune diseases. A high index of suspicion for syphilis and timely serological examination are crucial for early diagnosis and prompt treatment. Even if the ASPPC shows signs of spontaneous improvement, prompt and sufficient antibiotic treatment remains essential to prevent sight-threatening complications.

Keywords:

• Acute syphilitic posterior placoid chorioretinitis
• misdiagnosis
• syphilis
• systemic lupus erythematosus
• uveitis

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

This work was supported by the National Natural Science Foundation of China [81670875].