Atypical Syphilitic Outer Retinitis and Severe Retinal Vasculitis as Onset Manifestations in a Patient with Concurrent HIV and Syphilis Infection

ABSTRACT

Introduction

The most distinctive patterns of posterior pole affectation in syphilitic patients are acute posterior placoid chorioretinitis (ASPPC), pseudoretinitis pigmentosa and panuveitis with white focal preretinal opacities. However, outer retinitis is not a common presenting feature in this disease.

Case report

Thus, we report an atypical case of syphilitic outer retinitis (SOR) and severe retinal phlebitis as presenting manifestations in a patient with HIV and syphilis coinfection. We consider that this patient had mixed characteristics of SOR and ASPPC with features of acute zonal occult outer retinopathy (AZOOR) spectrum, which has only rarely been published in recent years.

Conclusion

Prompt and appropriate antibiotic treatment permitted total restoration of the external retinal layers, resolution of retinal vasculitis and recuperation of visual acuity. Since SOR is treatable in contrast to AZOOR, ophthalmologists should be aware that SOR needs to be ruled out when making a diagnosis of AZOOR.

KEYWORDS:

• Syphilis
• uveítis
• syphilitic retinitis
• outer retinitis
• AZOOR spectrum

Declaration of Interest

The authors report no conflict of interest.

Consent

We confirm the patient has given consent to the inclusion of figures, they acknowledge that they cannot be identified and that we have fully anonymized them.

Additional information

Funding

No funding has been received.