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Bilateral Optic Neuritis as Initial Manifestation of Neurosyphilis in a HIV-Positive Patient

Slavica Konjević-Pernar
Ivana Bednar
Katia Novak-Lauš
Ivanka Petric-Vicković
Zdravko Mandić


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Abstract

Syphilis, a disease which used to be terminal up to the 1950s, has become curable with the discovery of penicillin. In the last few years, an increase in its incidence has been recorded in the world as well as in Croatia, primarily with the human immunodeficiency virus (HIV) co-infection. We present a 40-year-old male patient who complained of a sudden decrease of visual acuity on both eyes, accompanied by dizziness. Clinical examination revealed low visual acuity and blurred edges of the optical nerve head without prominence. Pulse corticosteroid therapy failed to produce any recovery of visual acuity. Additional tests were done including Treponema pallidum hemagglutination assay (TPHA), which confirmed the infection with Treponema pallidum. The patient was administered Extencillin therapy. As a reaction to therapy administered, the patient.s visual acuity gradually fully recovered. In the medical literature available, there is no report of optical neuritis as the first and only manifestation of HIV and syphilis co-infection.

Keywords

Optic neuritis - diagnosis; Optic neuritis - drug therapy; HIV infections - complications; Syphilis - complications; Case report

Hrčak ID:

27233

URI

https://hrcak.srce.hr/27233

Publication date:

2.6.2008.

Article data in other languages: croatian

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