186
Views
1
CrossRef citations to date
0
Altmetric
Letters to the Editor

Penicillin Responsive Presumed Seronegative Ocular Syphilis in a Patient with Human Immunodeficiency Virus: A Case Report and Review of the Literature

, MD, MBA, , MD, , MD, , MD & , MD
Pages 1320-1327 | Received 05 Sep 2022, Accepted 17 Feb 2023, Published online: 10 Mar 2023

References

  • Davis LE, Schmitt JW. Clinical significance of cerebrospinal fluid tests for neurosyphilis. Ann Neurol. 1989 Jan;25(1):50–55. doi:10.1002/ana.410250108.
  • Hook III EW. Syphilis and HIV infection. J Infect Dis. 1989 Sep 1;160(3):530–534. doi:10.1093/infdis/160.3.530.
  • Zetola NM, Klausner JD. Syphilis and HIV infection: an update. Clin Infect Dis. 2007 May 1;44(9):1222–1228. doi:10.1086/513427.
  • Ortega KL, Rezende NP, Magalhães MH. Diagnosing secondary syphilis in a patient with HIV. British J of Oral and Maxillofacial Surg. 2009 Mar 1;47(2):169–170. doi:10.1016/j.bjoms.2008.08.002.
  • Haslett P, Laverty M. The prozone phenomenon in syphilis associated with HIV infection. Arch Internal Med. 1994 Jul 25;154(14):1643–1644. doi:10.1001/archinte.1994.00420140115016.
  • Kingston AA, Vujevich J, Shapiro M, et al. Seronegative secondary syphilis in 2 patients coinfected with human immunodeficiency virus. Arch Dermatol. 2005 Apr 1;141(4):431–433. doi:10.1001/archderm.141.4.431.
  • Erbelding EJ, Vlahov D, Nelson KE, et al. Syphilis serology in human immunodeficiency virus infection: evidence for false-negative fluorescent treponemal testing. J Infect Dis. 1997 Nov 1;176(5):1397–1400. doi:10.1086/517330.
  • Katz AR, Komeya AY, Tomas JE. False-negative syphilis treponemal enzyme immunoassay results in an HIV-infected case-patient. Int J STD AIDS. 2017 Jun;28(7):735–737. doi:10.1177/0956462416684426.
  • Johnson PD, Graves SR, Stewart L, Warren R, Dwyer B, Lucas CR. Specific syphilis serological tests may become negative in HIV infection. AIDS. 1991 Apr 1;5(4):419–423. doi:10.1097/00002030-199104000-00010.
  • Blum L, Bachmeyer C, Caumes E. Seronegative secondary syphilis in an HIV-infected patient. Clin Exp Dermatol. 2005 Mar;30(2):158–159. doi:10.1111/j.1365-2230.2004.01695.x.
  • Gregory N, Sanchez M, Buchness MR. The spectrum of syphilis in patients with human immunodeficiency virus infection. J Am Acad Dermatol. 1990;22(6):1061–1067. doi:10.1016/0190-9622(90)70153-9.
  • Schofer H, Imhof M, Thoma-Greber E, et al. Active syphilis in HIV infection: a multicentre retrospective survey. Genitourin Med. 1996;72176–72181.
  • Hicks CB, Benson PM, Lupton GP, Tramont EC. Seronegative secondary syphilis in a patient infected with the human immunodeficiency virus (HIV) with Kaposi sarcoma: a diagnostic dilemma. Ann Intern Med. 1987 Oct 1;107(4):492–494. doi:10.7326/0003-4819-107-4-492.
  • Chen X, Yang R, Liang Y, et al. Comparison and evaluation of Abbott chemiluminescent microparticle immunoassay and ChIVD light-initiated chemiluminescent assay in the detection of Treponema pallidum antibody. J Clin Lab Anal. 2020 Jul;34(7):e23275. doi:10.1002/jcla.23275.
  • Zhou J, Liang Y, Zhang J, Cui L. The analyzation and clinical evaluation of ECLIA and CMIA in the detection of Treponema pallidum. Medicine (Baltimore). 2017 Jun;96:24.
  • Terzi HA, Aydemir O, Karakece E, et al. Investigation of the rapid immunochromatographic test performance in the diagnosis of syphilis; comparison of four serological methods. J Lab Med. 2020 Aug 1;44(4):221–226. doi:10.1515/labmed-2019-0012.
  • Vrbová E, Mikalová L, Grillová L, et al. A retrospective study on nested PCR detection of syphilis treponemes in clinical samples: PCR detection contributes to the diagnosis of syphilis in patients with seronegative and serodiscrepant results. PloS one. 2020 Aug 20;15(8):e0237949. doi:10.1371/journal.pone.0237949.
  • Moir S, Fauci AS. B cells in HIV infection and disease. Nat Rev Immunol. 2009 Apr;9(4):235–245. doi:10.1038/nri2524.
  • Bowen DL, Lane HC, Fauci AS. Immunopathogenesis of the acquired immunodeficiency syndrome. Ann Intern Med. 1985 Nov 1;103(5):704–709. doi:10.7326/0003-4819-103-5-704.
  • Roberts CJ. Coccidioidomycosis in acquired immune deficiency syndrome: depressed humoral as well as cellular immunity. Am J Med. 1984 Apr 1;76(4):734–736. doi:10.1016/0002-9343(84)90304-8.
  • Luft B, Conley F, Remington J, et al. Outbreak of central-nervous-system toxoplasmosis in Western Europe and North America. Lancet. 1983 Apr 9;321(8328):781–784. doi:10.1016/S0140-6736(83)91847-0.
  • Dylewski J, Chou S, Merigan TC. Absence of detectable IgM antibody during cytomegalovirus disease in patients with AIDS. N Engl J Med. 1983 Aug 25;309(8):493.
  • Magri F, Donà MG, Panetta C, et al. Unusual clinical manifestation and challenging serological interpretation of syphilis: insights from a case report. BMC Infect Dis. 2021 Dec;21(1):1–5. doi:10.1186/s12879-021-06199-0.
  • Moir S, Fauci AS. Pathogenic mechanisms of B-lymphocyte dysfunction in HIV disease. J Allergy Clin Immunol. 2008 Jul 1;122(1):12–19. doi:10.1016/j.jaci.2008.04.034.
  • Palmer HM, Higgins SP, Herring AJ, Kingston MA. Use of PCR in the diagnosis of early syphilis in the United Kingdom. Sex Transm Infect. 2003 Dec 1;79(6):479–483. doi:10.1136/sti.79.6.479.
  • Motlagh MN, Javid CG. Presentation of ocular syphilis in a HIV-positive patient with false-negative serologic screening. Case Reports in Infectious Diseases. 2019 Feb 3.
  • Tucker JD, Li JZ, Robbins GK, et al. Ocular syphilis among HIV-infected patients: a systematic analysis of the literature. Sex Transm Infect. 2011 Feb 1;87(1):4–8. doi:10.1136/sti.2010.043042.
  • Halperin LS. Neuroretinitis due to seronegative syphilis associated with human immunodeficiency virus. J Clin Neuro-Ophthalmol. 1992 Sep 1;12(3):171–172.
  • Centers for Disease Control and Prevention. Table 1. sexually transmitted diseases - reported cases and rates of reported cases, United States, 1941–2019 [Internet]. 2021. https://www.cdc.gov/std/statistics/2019/tables/1.htm. Accessed May 21, 2022.
  • Oliver SE, Aubin M, Atwell L, et al. Ocular syphilis—eight jurisdictions, United States, 2014–2015. Morbidity Mortality Weekly Rep. 2016 Nov 4;65(43):1185–1188. doi:10.15585/mmwr.mm6543a2.
  • Gurney CE, Danbolt N. The Oslo study of the natural course of untreated syphilis: an epidemiologic investigation based on a re-study of the Boeck-Bruusgaard material. Med Clin North Am. 1964;48:613–623. doi:10.1016/S0025-7125(16)33445-9.
  • Dutta Majumder P, Chen EJ, Shah J, et al. Ocular syphilis: an update. Ocul Immunol Inflamm. 2019 Jan 2;27(1):117–125. doi:10.1080/09273948.2017.1371765.
  • Aldave AJ, King JA, Cunningham ET. Ocular syphilis. Curr Opin Ophthalmol. 2001 Dec 1;12(6):433–441. doi:10.1097/00055735-200112000-00008.
  • Kiss S, Damico FM, Young LH. Ocular manifestations and treatment of syphilis. Semin Ophthalmol. 2005 Jan 1;20(3):161–167.
  • Furtado JM, Arantes TE, Nascimento H, et al. Clinical manifestations and ophthalmic outcomes of ocular syphilis at a time of re-emergence of the systemic infection. Sci Rep. 2018 Aug 13;8(1):1–8. doi:10.1038/s41598-017-17765-5.
  • Hu KS, Vitale AT, Shakoor A, et al. Pyramidal inflammatory deposits of the retinal pigment epithelium and outer retina in ocular syphilis. Ophthalmol Retina. 2022 Feb 1;6(2):172–178.
  • Wickremasinghe S, Ling C, Stawell R, Yeoh J, Hall A, Zamir E. Syphilitic punctate inner retinitis in immunocompetent gay men. Ophthalmology. 2009 Jun 1;116(6):1195–1200. doi:10.1016/j.ophtha.2008.12.055.
  • Gass JD, Braunstein RA, Chenoweth RG. Acute syphilitic posterior placoid chorioretinitis. Ophthalmology. 1990 Oct 1;97(10):1288–1297. doi:10.1016/S0161-6420(90)32418-1.
  • Ji YS, Yang JM, Park SW. Early resolved acute syphilitic posterior placoid chorioretinitis. Optometry Vision Sci. 2015 Apr 1;92(4S):S55–8. doi:10.1097/OPX.0000000000000531.
  • Brito P, Penas S, Â C, Palmares J, Reis FF. Spectral-domain optical coherence tomography features of acute syphilitic posterior placoid chorioretinitis: the role of autoimmune response in pathogenesis. Case Rep Ophthalmol. 2011;2(1):39–44. doi:10.1159/000324086.
  • Ormaechea MS, Hassan M, Nguyen QD, Schlaen A. Acute syphilitic posterior placoid chorioretinopathy: an infectious or autoimmune disease? Am J Ophthalmol Case Rep. 2019 Jun;1(14):70–73. doi:10.1016/j.ajoc.2019.03.002.
  • Burkholder BM, Leung TG, Ostheimer TA, Butler NJ, Thorne JE, Dunn JP. Spectral domain optical coherence tomography findings in acute syphilitic posterior placoid chorioretinitis. J Ophthalmic Inflamm Infect. 2014 Dec;4(1):1–5. doi:10.1186/1869-5760-4-2.
  • Pope V, Norris SJ, Johnson RE. Treponema and other human host-associated spirochetes. In: Clin Microbiol. Vol. 1. 9th ed. Washington, DC: ASM Press; 2006:987–1003.
  • Ghanem KG, Erbelding EJ, Wiener ZS, Rompalo AM. Serological response to syphilis treatment in HIV-positive and HIV-negative patients attending sexually transmitted diseases clinics. Sex Transm Infect. 2007 Apr 1;83(2):97–101. doi:10.1136/sti.2006.021402.
  • Ratnam S. The laboratory diagnosis of syphilis. Can J Infect Dis Med Microbiol. 2005 Jan 1;16(1):45–51. doi:10.1155/2005/597580.
  • Diagnostics Direct LLC. 510(k) substantial equivalence determination decision summary #K102400. 2011. http://www.accessdata.fda.gov/cdrh_docs/reviews/k102400.pdf. Accessed May 19, 2015.
  • Seña AC, White BL, Sparling PF. Novel Treponema pallidum serologic tests: a paradigm shift in syphilis screening for the 21st century. Clin Infect Dis. 2010 Sep 15;51(6):700–708. doi:10.1086/655832.
  • Marangoni A, Sambri V, Accardo S, et al. Evaluation of LIAISON Treponema Screen, a novel recombinant antigen-based chemiluminescence immunoassay for laboratory diagnosis of syphilis. Clin Vaccine Immunol. 2005 Oct;12(10):1231–1234. doi:10.1128/CDLI.12.10.1231-1234.2005.
  • Binnicker MJ, Jespersen DJ, Rollins LO. Treponema-specific tests for serodiagnosis of syphilis: comparative evaluation of seven assays. J Clin Microbiol. 2011 Apr;49(4):1313–1317. doi:10.1128/JCM.02555-10.
  • Larsen SA, Steiner BM, Rudolph AH. Laboratory diagnosis and interpretation of tests for syphilis. Clin Microbiol Rev. 1995 Jan;8(1):1–21. doi:10.1128/CMR.8.1.1.
  • Lesiński J, Krach J, Kadziewicz E. Specificity, sensitivity, and diagnostic value of the TPHA test. Br J Vener Dis. 1974 Oct;50(5):334. doi:10.1136/sti.50.5.334.
  • Cantor A, Nelson HD, Daeges M, Pappas M. Screening for syphilis in nonpregnant adolescents and adults: systematic review to update the 2004 US preventive services task force recommendation: evidence synthesis No. 136. Rockville, MD: Agency for Healthcare Research and Quality; 2016. AHRQ publication 14-05213-EF-1.
  • Soreng K, Levy R, Fakile Y. Serologic testing for syphilis: benefits and challenges of a reverse algorithm. Clin Microbiol Newsl. 2014 Dec 15;36(24):195–202.
  • Lee JH, Lim CS, Lee MG, Kim HS. Evaluation of a rapid immunochromatographic treponemal antibody test comparing the Treponema pallidum particle agglutination assay. J Clin Lab Anal. 2015 Sep;29(5):383–386. doi:10.1002/jcla.21783.
  • Park IU, Tran A, Pereira L, Fakile Y. Sensitivity and specificity of treponemal-specific tests for the diagnosis of syphilis. Clin Infect Dis. 2020 Jun 24;71(Supplement_1):S13–20. doi:10.1093/cid/ciaa349.
  • Hicks CB, Clement M. Syphilis: Screening and Diagnostic Testing [Internet]. Mitty J, editor. https://www.uptodate.com/contents/syphilis-screening-and-diagnostic-testing?search=syphilis%20testing&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H601231816. UpToDate. 2021. Accessed May 30, 2022
  • Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep. 2021 Jul 23;70(4):1. doi:10.15585/mmwr.rr7004a1.
  • Seña AC, Zhang XH, Li T, et al. A systematic review of syphilis serological treatment outcomes in HIV-infected and HIV-uninfected persons: rethinking the significance of serological non-responsiveness and the serofast state after therapy. BMC Infect Dis. 2015 Dec;15(1):1–5. doi:10.1186/s12879-015-1209-0.
  • Troutbeck R, Chhabra R, Jones NP. Polymerase chain reaction testing of vitreous in atypical ocular syphilis. Ocul Immunol Inflamm. 2013 Jun 1;21(3):227–230. doi:10.3109/09273948.2013.770887.
  • Rajan MS, Pantelidis P, Tong CY, French GL, Graham EM, Stanford MR. Diagnosis of Treponema pallidum in vitreous samples using real time polymerase chain reaction. British J Ophthalmol. 2006 May 1;90(5):647–648. doi:10.1136/bjo.2005.083196.
  • Booth J, Rodger A, Singh J, Alexander S, Hopkins S. Syphilitic panuveitis with retinal necrosis in an HIV positive man confirmed by Treponema pallidum PCR. J Infect. 2009 Nov 1;59(5):373–375. doi:10.1016/j.jinf.2009.08.022.
  • Müller M, Ewert I, Hansmann F, et al. Detection of Treponema pallidum in the vitreous by PCR. British J Ophthalmol. 2007 May 1;91(5):592–595. doi:10.1136/bjo.2006.110288.
  • Cornut PL, Sobas CR, Perard L, et al. Detection of Treponema pallidum in aqueous humor by real-time polymerase chain reaction. Ocul Immunol Inflamm. 2011 Apr 1;19(2):127–128. doi:10.3109/09273948.2010.531175.
  • Nair N, Sudharshan S, Anand AR, Biswas J, Therese KL. Utility of treponemal testing from aqueous fluid in the diagnosis of ocular syphilis in patients with HIV/AIDS. Ocul Immunol Inflamm. 2022 Feb 17;30(2):444–450. doi:10.1080/09273948.2020.1803362.
  • Silpa-Archa S, Preble JM, Foster CS. Vitreous treponemal antibody as a supplementary test to serology for the confirmation of syphilitic chorioretinitis. Retinal Cases Brief Rep. 2020 Apr 1;14(2):166–169. doi:10.1097/ICB.0000000000000676.
  • Silpa-Archa S, Hoopholerb T, Foster CS. Appraisal of vitreous syphilis antibody as a novel biomarker for the diagnosis of syphilitic uveitis: a prospective case-control study. Eye. 2022 Jan;16:1–9.
  • Amaratunge BC, Camuglia JE, Hall AJ. Syphilitic uveitis: a review of clinical manifestations and treatment outcomes of syphilitic uveitis in human immunodeficiency virus-positive and negative patients. Clin Exp Ophthalmol. 2010 Jan;38(1):68–74. doi:10.1111/j.1442-9071.2010.02203.x.
  • Lapere S, Mustak H, Steffen J. Clinical manifestations and cerebrospinal fluid status in ocular syphilis. Ocul Immunol Inflamm. 2019 Jan 2;27(1):126–130. doi:10.1080/09273948.2018.1521436.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.