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TitreRetrospective study of syphilitic uveitis in a cohort of patients from CHU Saint-Pierre, Brussels
ButDescription of the clinical presentation and outcome of patients with syphilitic uveitis.
MéthodesRetrospective study of 11 patients with ocular syphilis seen in our centre between 2003 and 2012. The diagnosis of syphilitic uveitis was based on clinical evidence of intraocular inflammation not attributable to other causes and positive serology for syphilis (treponemal and non treponemal tests). Following data were recorded: age, gender, HIV status, CD4 cell count in AIDS patients, ocular manifestations, serum and cerebrospinal fluid (CSF) analysis, treatment and ocular sequelae.
Résultats15 eyes of 11 patients (10 men, 1woman) were included. Mean age at diagnosis was 36 year. Risk factors were identified in 7 cases: homosexuality in 6, drug abuse in 1. 45% were seropositive for HIV-1 with a mean CD4 cell counts of 567.6 cells/mm³. We found 8 posterior uveitis, 3 papillitis, 4 panuveitis. Ten patients had CSF analysis and 7 of them had pleiocytosis. All were treated with IV antibiotics. Final ocular presentations were normalization (4/11), retinal atrophy (5/11), salt and pepper retina (3/11), epiretinal membrane (1/11), cystoid macular oedema (1/11) and diffuse capillaropathy (1/11).
ConclusionIn our series, syphilitic uveitis was found in healthy patients and HIV homosexual men with an over all good CD4 cell count. Clinical presentation was not specific but more than 50% had posterior uveitis. CSF analysis was negative in 33% of cases, suggesting that uveitis is not always concomitant with a neurosyphilis. IV treatment is effective but sequelae can occur in some patients.
Auteur 1
NomLHOIR
InitialesS.
InstitutCHU Saint Pierre/ Brugmann, ULB
VilleBruxelles
Auteur 2
NomMakhoul
InitialesD
InstitutCHU Saint Pierre/ Brugmann
VilleBruxelles
Auteur 3
NomLibois
InitialesA
InstitutCHU Saint Pierre
VilleBruxelles
Auteur 4
NomCaspers
InitialesL
InstitutCHU Saint Pierre
VilleBruxelles
Auteur 5
NomWillermain
InitialesF
InstitutCHU Saint Pierre/ Brugmann, ULB
VilleBruxelles
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