Ocular Syphilis as a Cause of Chronic Postoperative Uveitis Followed by a Localized Ocular Jarisch–Herxheimer-like Reaction

ABSTRACT

Objective

The case draws attention to syphilis as a cause of chronic postoperative uveitis following cataract surgery and is the first to document transient worsening of ocular inflammation without systemic symptoms after initiation of treatment, suggesting a localized Jarisch–Herxheimer-like reaction.

Design

Case report.

Results

The average thickness of the retinal nerve fiber layer was used as an objective measure of intraocular inflammation. The patient’s nerve edema worsened during a standard neurosyphilis treatment course and returned to normal several weeks after completion of therapy.

Conclusion

Syphilis serologic testing should be strongly considered in the work-up for chronic postoperative uveitis. A localized ocular Jarisch–Herxheimer-like reaction may occur and should not detract from completion of neurosyphilis treatment.

KEYWORDS:

• Ocular syphilis
• neurosyphilis
• latent syphilis
• postoperative uveitis
• Jarisch-Herxheimer reaction

Acknowledgments

The authors do not have any conflicts of interest to disclose.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.