Ocular syphilis and neurosyphilis in patients with HIV infection. Report on two cases of serological tests non  reactive at the beginning and revision of the literature

A Velásquez-Lupi; P Cornejo-Juárez; G Ortega-Larrocea; Villasis-Keever; JJ Calva-Mercado; GM Ruiz-Palacios; J Sierra-Madero

2001, Number 2

Enf Infec Microbiol 2001; 21 (2)

Ocular syphilis and neurosyphilis in patients with HIV infection. Report on two cases of serological tests non reactive at the beginning and revision of the literature

Velásquez-Lupi A, Cornejo-Juárez P, Ortega-Larrocea G, Villasis-Keever, Calva-Mercado JJ, Ruiz-Palacios GM, Sierra-Madero J

Full text

How to cite this article

Language: Spanish
References: 18
Page: 49-53
PDF size: 94.66 Kb.

ABSTRACT

Ocular syphilis is the most common bacterial infection in the eye in HIV infected patients. It can present initially as a unilateral vitritis and in late stages as a bilateral panuveitis and neurosyphilis. Diagnosis is made based on two types of serological tests: treponemal and non-treponemal, however both types may be non reactive at the beginning of the disease as we demonstrate in two clinical cases presented here. We strongly recommend considering this diagnosis in HIV infected patients with uveitis.

REFERENCES

Malone J, Wallace M, Hendrick B, et al. Syphilis and neurosyphilis in a human immunodeficiency virus type-1 seropositive population: evidence for frequent serologic relapse after therapy. Am J Med 1995;99:55-63.
Haas J, Bolan G, Larsen S, Clement M, Bacchetti P, Moss A. Sensitivity or treponemal tests for detection prior treated syphilis during human immunodeficiency virus infection. J Infect Dis 1990;162:862-6.
Yinnon A, Coury-Doninger P, Polito R, Reichman R. Serologic response to treatment of syphilis in patients with HIV infection. Arch Intern Med 1996;156:321-5.
Hutchinson C, Hook E, Sheperd M, Verley J, Rompalo A. Altered clinical presentation of early syphilis in patients with human immunodeficiency virus infection. Ann Intern Med 1994;121:94-99.
Musher D, Hamill R, Baughn R. Effect of human immunodeficiency virus (HIV) infection on the course of syphilis and on the response to treatment. Ann Intern Med 1990;113:872-81.
Cunningham E, Margolis T. Ocular manifestations of HIV infection. N Engl J Med 1998;339;236-44.
Kuo I, Kapusta M, Rao N. Vitritis as the primary manifestation of ocular syphilis in patients with HIV infection. Am J Ophthalmology 1998;125:306-311.
Becerra L, Ksiazek S, Sabino P, et al. Syphilitic uveitis in human immunodeficiency virus-infected and no-infected patients. Ophthalmology 1989;96:1727-30.
McLeish W, Pulido J, Holland S, Culbertson W, Winward K. The ocular manifestations of syphilis in the human immunodeficiency virus type-1 infected host. Ophthalmology 1990;97:196-203.
Rodríguez A, Stephe F. Infecciones oculares en pacientes con el síndrome de inmunodeficiencia humana. Enf Inf y Microbiol 1994;14:407-15.
Shalaby I, Dunn J, Jabs D. Syphilitic uveitis in human immunodeficiency virus infected patients. Arch Ophthalmol 1997;115:469-73.
Passo M, Rosenbaum J. Ocular syphilis in patients with human immunodeficiency virus infection. Am J Ophthalmol 1988;106:1-6.
Tamesis R, Foster S. Ocular syphilis. Ophthalmology 1990; 97:1281-7.
Hook E, Marra C. Acquired syphilis in adults. N Engl J Med 1992;326:1060-9.
Muscher D. Syphilis, neurosyphilis, penicillin, and AIDS. J Infect Dis 1991;163:1201-6.
Sexually transmitted diseases treatment guidelines. MMWR 1998;47:28-45.
Flood JM, Weinstock HS, Guroy ME, Bayne L, Simon RP, Bolan G. Neurosyphilis during the AIDS epidemic, San Francisco, 1985-1992. J Infect Dis 1998;177:931-1229.
Hicks CB, Benson PM, Lupton GP, Tramont EC. Seronegative secondary syphilis in a patient infected with human immunodeficiency virus (HIV) with Kaposi sarcoma. Ann Int Med 1987;107:492-494.