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  • Title: [Primary diagnosis of syphilis by the ophthalmologist].
    Author: Porstmann AU, Marcus U, Pleyer U.
    Journal: Klin Monbl Augenheilkd; 2002 May; 219(5):349-52. PubMed ID: 12094316.
    Abstract:
    BACKGROUND: Throughout the developed world the reported incidence of sexually transmitted diseases is rising with previously unreported cases at rates of 40 - 70 %. According to German sources, recent epidemiological data show a considerable increase of syphilis especially among homosexual men in larger cities. PATIENTS: We report on 4 patients (age 38 - 54) who were referred to our outpatient department because of vision loss of unknown origin. All were subsequently tested positive for syphilis. None of the patients (3 men, 1 woman) belonged to a risk group, only one described systemic symptoms (urethritis and arthritis). The ocular manifestations of syphilis were broad: granulomatous and non-granulomatous anterior uveitis, papillitis, and chorioretinitis. Two patients also tested positive for HIV. After systemic antibiotic therapy, the ocular diseases stabilized. CONCLUSION: Diagnosis and therapy of syphilis is cost-effective. The rise of syphilis especially in urban areas necessitates a high level of suspicion dealing with patients with intraocular inflammation of unknown origin. Lues serology should be incorporated into routine lab diagnostics to aid in the detection of such cases.
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