Journal Article

Syphilitic Posterior Uveitis: Correlative Findings and Significance

L. David Ormerod, James E. Puklin and Jack D. Sobel

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 32, issue 12, pages 1661-1673
Published in print June 2001 | ISSN: 1058-4838
Published online June 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/320766
Syphilitic Posterior Uveitis: Correlative Findings and Significance

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Twenty-one patients with syphilitic posterior uveitis were investigated retrospectively to study the disease spectrum, associations with neurosyphilis, and therapeutic implications. Ophthalmologic manifestations of syphilitic posterior uveitis are differentiated into acute and chronic uveitides. The several distinct acute uveitic syndromes are usually florid and are associated with early syphilis, with VDRL-positive syphilitic meningitis, and frequently with human immunodeficiency virus coinfection. The chronic posterior uveitides are often insidious, a manifestation of late syphilis, and associated commonly with subclinical neurosyphilis. All patients with acute cases and 54% of patients with chronic cases in our study received penicillin therapy appropriate for neurosyphilis. The frequent association of syphilitic posterior uveitis with neurosyphilis and the analogous spirochetal sequestration beyond the blood-brain and the blood-ocular barriers suggest that all patients with syphilitic posterior uveitis, irrespective of ocular disease intensity, should undergo evaluation of cerebrospinal fluid and be treated with penicillin regimens appropriate for neurosyphilis.

Journal Article.  6038 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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