scholarly journals Syphilis-Related Eye Disease Presenting as Bilateral Papilledema, Retinal Nerve Fiber Layer Hemorrhage, and Anterior Uveitis in a Penicillin-Allergic Patient

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Jamie Dietze ◽  
Shane Havens
Keyword(s):  
Vision Loss ◽  
Clinical Course ◽  
Treponema Pallidum ◽  
Allergic Patient ◽  
Eye Disease ◽  
Fiber Layer ◽  
Retinal Hemorrhages ◽  
Ocular Manifestations ◽  
Immunodeficiency Virus ◽  
Tertiary Stage

Purpose. Treponema pallidum is known as the “great masquerader” for its many presentations and ocular findings in patients who are infected and develop secondary and tertiary stage of syphilis. Syphilitic ocular manifestations include uveitis, chorioretinitis, retinitis, vasculitis, vitritis, and panuveitis all with or without decreased visual acuity. Human immunodeficiency virus (HIV) is known to expedite the progression of syphilis when patients are coinfected, thus compounding the potential ophthalmic presentations. This report summarizes the presentation, management, and clinical course of a patient with known HIV and penicillin allergy that presented with bilateral optic nerve edema, retinal hemorrhages, and iritis without vision loss.

scholarly journals Secondary Syphilis in Human Immunodeficiency Virus (HIV)-Infected Men Who Have Sex with Men (MSM): A Case Report

2020 ◽  
Vol 32 (1) ◽  
pp. 75
Author(s):  
Ade Fernandes ◽  
Evy Ervianti
Keyword(s):  
Human Immunodeficiency Virus ◽  
Treatment Success ◽  
Venereal Disease ◽  
Treponema Pallidum ◽  
Clinical Manifestations ◽  
Secondary Syphilis ◽  
Response To Treatment ◽  
Immunodeficiency Virus ◽  
Tertiary Stage ◽  
Sex With Men

Background: Recently, the incidence of syphilis among men who have sex with men (MSM) has increased rapidly, especially among Human Immunodeficiency Virus (HIV)-infected MSM. Coinfection with these two organisms alter the symptoms and signs, progression of the disease, and the risk of progressing to the tertiary stage. Purpose: To report a case of secondary syphilis in HIV-infected MSM.  Case: A 24-year-old male complaint of multiple redness macule for 1-month duration on his chest, back, groin, palm, and soles. The rash was neither painful nor pruritic. He also complains of hair loss resulting "moth eaten" alopecia. One month before, he had a painless ulcer on his genital, which resolved without treatment. His HIV infection was diagnosed two years earlier. He had been sexually active with multiple homosexual partners without using a condom since 2010. The Venereal Disease Research Laboratory test (VDRL) titer was 1/32, and Treponema pallidum haemagglutination assay (TPHA) was 1/20480. Initial treatment was a single dose of 2.4 million units of benzathine penicillin. Serologic examination was reevaluated on month 1, 3, 6, and 9 after therapy and declined in the third month. Discussion: For HIV-infected persons, the clinical manifestations of syphilis in most of the cases remain the same. However, the lesions are more aggressive, and coexistence of primary and secondary syphilis is more frequent. Serologic tests are accurate and reliable for the diagnosis and for following a patient’s response to treatment. Penicillin is effective but physical and serological follow up is needed. Conclusion: HIV-infected MSM have higher risk of syphilis. Staging is needed to determine the treatment. Serologic examination should be repeated and long enough to monitor the treatment success.

scholarly journals Neurosyphilis Presenting with Optic Neuritis

2021 ◽  
Vol 2 (5) ◽  
pp. 1-3
Author(s):  
S. C. Reddy
Keyword(s):  
Optic Neuritis ◽  
Optic Disc ◽  
Vision Loss ◽  
Anterior Segment ◽  
First Episode ◽  
Ocular Manifestations ◽  
Interstitial Keratitis ◽  
Immunodeficiency Virus ◽  
Optic Disc Swelling ◽  
The Right

The incidence of syphilis has greatly reduced in the severity of affected individuals due to the early treatment with antibiotics. However, due to the increase in the prevalence of human immunodeficiency virus (HIV) infection, it has also caused a concurrent rise in the number of neurosyphilis patients. Most common ocular manifestations include uveitis, interstitial keratitis, and vasculitis. A healthy 28-years old man presented with a progressive blurring of vision in the right eye for one month. It was his second episode. The first episode occurred 4 months back which resolved spontaneously without treatment. Vision in the right eye was 6/18. The pupil was dilated and the relative afferent pupillary defect was positive. Fundus examination showed a hyperemic swollen right optic disc with blurred margins and no macular fan or star. Vision, anterior segment, and fundus were normal in the left eye. After the investigations, he was diagnosed as a case of neurosyphilis with optic neuritis. He was treated with intravenous penicillin for two weeks followed by oral penicillin for three weeks. Vision in the right eye improved to 6/6; the optic disc swelling resolved with clear margins. He maintained good vision during the follow-up of six months. Early referral to an ophthalmologist upon suspicion of syphilis, detailed evaluation, and immediate treatment is mandatory to prevent permanent vision loss in these patients.

scholarly journals Ocular manifestation in human immunodeficiency virus patients presenting to tertiary eye care centre in rural area

2021 ◽  
Vol 7 (2) ◽  
pp. 363-365
Author(s):  
Nehal Nareshkumar Mohata ◽  
Saud Gafur Deshmukh ◽  
Sudhir Sudhakar Pendke ◽  
Akshay Rajeshwar Padgilwar ◽  
Sunil Devrao Dokhale
Keyword(s):  
Anterior Segment ◽  
Cd4 T Cell ◽  
Eye Disease ◽  
Ocular Diseases ◽  
Early Presentation ◽  
Delay In Diagnosis ◽  
Ocular Manifestations ◽  
Immunodeficiency Virus ◽  
Cd4 T Cell Count ◽  
Hiv Aids

The ocular manifestations of HIV/AIDS may lead to visual impairment or blindness. The need of hour is an understating of ocular sequelae of HIV infection leading to an early diagnosis of AIDS so that we can start early and effective treatment as per conditions.1. To study the prevalence of ocular manifestations in HIV patients; 2. To study relation of CD4 T Cell count with ocular diseases. The study concluded that HIV/AIDS is a significant cause of ocular disease. Almost around 39% patients having HIV/AIDS have eye disease. HIV Retinopathy is most common in posterior segment and lens involvement is most common in anterior segment manifestations. Usually, early presentation of ocular manifestations in HIV/AIDS patients is asymptomatic or with very less symptoms, which leads to delay in diagnosis and treatment.

scholarly journals Gag sequence variation in a human immunodeficiency virus type 1 transmission cluster influences viral replication fitness

2013 ◽  
Vol 94 (2) ◽  
pp. 354-359 ◽  
Author(s):  
Esther F. Gijsbers ◽  
Ad C. van Nuenen ◽  
Hanneke Schuitemaker ◽  
Neeltje A. Kootstra
Keyword(s):  
Human Immunodeficiency Virus ◽  
Human Immunodeficiency Virus Type ◽  
Sequence Variation ◽  
Clinical Course ◽  
Immunodeficiency Virus ◽  
Compensatory Mutations ◽  
Replication Fitness ◽  
Hiv 1

Three men from a proven homosexual human immunodeficiency virus type 1 (HIV-1) transmission cluster showed large variation in their clinical course of infection. To evaluate the effect of evolution of the same viral variant in these three patients, we analysed sequence variation in the capsid protein and determined the impact of the observed variation on viral replication fitness in vitro. Viral gag sequences from all three patients contained a mutation at position 242, T242N or T242S, which have been associated with lower virus replication in vitro. Interestingly, HIV-1 variants from patients with a progressive clinical course of infection developed compensatory mutations within the capsid that restored viral fitness, instead of reversion of the T242S mutation. In HIV-1 variants from patient 1, an HLA-B57+ elite controller, no compensatory mutations emerged during follow-up.

scholarly journals Updates on the understanding and management of thyroid eye disease

2021 ◽  
Vol 13 ◽  
pp. 251584142110277
Author(s):  
Clara J. Men ◽  
Andrea L. Kossler ◽  
Sara T. Wester
Keyword(s):  
Autoimmune Diseases ◽  
Immune Modulation ◽  
Complex Disease ◽  
Vision Loss ◽  
Treatment Options ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Eye Disease ◽  
Eye Disease ◽  
Signaling Complex ◽  
Clinical Trial Results

Thyroid eye disease (TED) is a complex disease associated with myriad clinical presentations, including facial disfigurement, vision loss, and decreased quality of life. Traditionally, steroid therapy and/or radiation therapy were commonly used in the treatment of active TED. While these therapies can help reduce inflammation, they often do not have a sustainable, significant long-term effect on disease outcomes, including proptosis and diplopia. Recent advances in our understanding of the pathophysiology of TED have shifted the focus of treatment toward targeted biologic therapies. Biologics have the advantage of precise immune modulation, which can have better safety profiles and greater efficacy compared to traditional approaches. For instance, the insulin-like growth factor-1 receptor (IGF-1R) has been found to be upregulated in TED patients and to colocalize with the thyroid-stimulating hormone receptor (TSHR), forming a signaling complex. Teprotumumab is an antibody targeted against IGF-1R. By inhibiting the IGF-1R/TSHR signaling pathway, teprotumumab may reduce the production of proinflammatory cytokines, hyaluronan secretion, and orbital fibroblast activation in patients with TED. Due to promising phase II and III clinical trial results, teprotumumab has become the first biologic US Food and Drug Administration (FDA)-approved for the treatment of TED. In addition, there are currently ongoing studies looking at the use of antibodies targeting the neonatal Fc receptor (FcRn) in various autoimmune diseases, including TED. FcRn functions to transport immunoglobulin G (IgG) and prevent their lysosomal degradation. By blocking the recycling of IgG, this approach may dampen the body’s immune response, in particular the pathogenic IgG implicated in some autoimmune diseases. Advances in our understanding of the pathophysiology of TED, therefore, are leading to more targeted therapeutic options, and we are entering an exciting new phase in the management of TED. This review will cover recent insights into the understanding of TED pathophysiology and novel treatment options as well as ongoing studies of new potential treatment options for TED.

scholarly journals HIV infection and multiple sclerosis: a case with unexpected “no evidence of disease activity” status

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052199957
Author(s):  
Fernando Labella ◽  
Fernando Acebrón ◽  
María del Carmen Blanco-Valero ◽  
Alba Rodrígez-Martín ◽  
Ángela Monterde Ortega ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Hiv Infection ◽  
Disease Activity ◽  
Demyelinating Disease ◽  
Clinical Course ◽  
Disease Modifying Drugs ◽  
Immunodeficiency Virus ◽  
Relapsing Remitting ◽  
The Central Nervous System ◽  
Disease Modifying

Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system whose etiology remains unclear. It has been suggested that MS can be triggered by certain viruses; however, human immunodeficiency virus (HIV) infection is associated with reduced incidence of MS. We present the case of a young patient diagnosed with active relapsing-remitting MS whose clinical course substantially improved following HIV infection and treatment. The patient achieved no evidence of disease activity status without any disease-modifying drugs. Both HIV-induced immunosuppression and antiretroviral therapy may have attenuated the clinical course in this patient.

scholarly journals Prevalence of Sexually Transmitted Diseases and Transmission of HIV in Dhaka, Bangladesh

2009 ◽  
Vol 3 (1) ◽  
pp. 27-33
Author(s):  
Tahmina Shirin ◽  
Saidur Rahman ◽  
Fareha Jesmin Rabbi ◽  
Md Humayun Kabir ◽  
KZ Mamun
Keyword(s):  
Human Immunodeficiency Virus ◽  
Herpes Simplex ◽  
Chlamydia Trachomatis ◽  
Sexually Transmitted Diseases ◽  
Treponema Pallidum ◽  
Enzyme Linked Immunosorbent Assay ◽  
Sexually Transmitted ◽  
Immunodeficiency Virus ◽  
Simplex Virus

The prevalence of sexually transmitted diseases (STDs) among patients attending out patients department of Skin and Venereal diseases of Dhaka Medical College Hospital, Dhaka and Shahid Sohrawardy Hospital, Dhaka was studied. A total of 230 patients were enrolled in the study during the period of July, 2006 to May, 2007. Urethral and endocervical swabs were collected from the participants for detection of Neisseria gonorrheae (by culture), Chlamydia trachomatis (by immunochromatoghraphy) and blood samples for the detection of Treponema pallidum antibody (by rapid plasma regain and Treponema pallidum haemagglutination assay), Herpes simplex virus type 2 antibody (both IgM and IgG by enzyme linked immunosorbent assay) and Human Immunodeficiency virus antibody (by enzyme linked immunosorbent assay). Socio-demographic data and data regarding high-risk sexual behavior were also collected. Out of 230 participants, 199 (86.5%) were positive for STDs pathogens studied, among them, 98 (42.6%) were infected with single pathogen and 101 (43.9%) were suffering from multiple infections. The prevalences of N. gonorrheae, C. trachomatis, T. pallidum, and HSV type 2 were 90 (39.1%), 110 (47.8%), 28 (12.2%) and 88 (38.2%) respectively. However, none of them were positive for HIV infection. Use of condom was significantly associated with protection of the participants against STDs. Keywords: Sexually Transmitted Diseases, Neisseria gonorrhoeae, Chlamydia trachomatis, Treponema pallidum, Herpes simplex virus type-2, Human Immunodeficiency virus   doi: 10.3329/bjmm.v3i1.2968 Bangladesh J Med Microbiol 2009; 03 (01): 27-33

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