The Great Imitator: Syphilitic Uveitis

2019 ◽  
pp. 283-289
Keyword(s):  
Human Immunodeficiency Virus ◽  
Developed Countries ◽  
Posterior Uveitis ◽  
Clinical Findings ◽  
Clinical Suspicion ◽  
Serological Tests ◽  
Young Males ◽  
Ocular Syphilis ◽  
Immunodeficiency Virus ◽  
Fluid Sampling

Syphilis is an important etiology of uveitis because of its curable nature. The prevalence of syphilis is increasing in developed countries especially among young males. Special consideration to its coexistence with the Human immunodeficiency virus (HIV) should be given. Since ocular syphilis can mimic most of the types of uveitis, it should be considered in the differential diagnosis of all types of uveitis. Syphilis causes posterior uveitis and panuveitis more frequently and its main clinical findings are focal preretinal white opacities and acute posterior placoid uveitis. Although imaging methods are utilized in the diagnosis, serological tests performed after clinical suspicion should be the main diagnostic approach. Knowing the pearls of the nontreponemal and treponemal serological tests is very important. All cases with ocular syphilis should be treated like neurosyphilis. Cerebrospinal fluid sampling should be performed in all ocular syphilis patients and all patients should be screened for HIV infection.

scholarly journals Clinical Manifestations and Treatment Outcomes of Syphilitic Uveitis in a Chinese Population

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Rui Zhang ◽  
Jiang Qian ◽  
Jie Guo ◽  
Yifei Yuan ◽  
Kang Xue ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Treatment Outcomes ◽  
Chinese Population ◽  
Retinal Vasculitis ◽  
Clinical Manifestations ◽  
Case Series ◽  
Posterior Uveitis ◽  
Retrospective Case ◽  
Serological Tests ◽  
Immunodeficiency Virus

Purpose. To describe the clinical manifestations and treatment outcomes of syphilitic uveitis in a Chinese population.Methods. This is a retrospective case series of 15 consecutive patients with syphilitic uveitis treated at a uveitis referral center between 2012 and 2015.Results. Fifteen patients were diagnosed with syphilitic uveitis based on positive serological tests. Nine patients were male. Coinfection with human immunodeficiency virus was detected in two patients. Twenty eyes presented with panuveitis and all patients had posterior involvement. The most frequent manifestations were retinal vasculitis and papillitis, while syphilitic posterior placoid chorioretinitis was only found in three eyes. All patients received systemic penicillin therapy according to CDC guidelines. Nine patients were misdiagnosed before presenting to our center and the delay in treatment with penicillin was associated with poor final visual outcomes (P<0.05).Conclusions. In our series, both male and female were almost equally affected and coinfection of syphilis with human immunodeficiency virus was uncommon. All patients in this study had posterior involvement and the most common manifestations were retinal vasculitis and papillitis. Syphilis should be considered as an important differential diagnosis especially for posterior uveitis and panuveitis. Early diagnosis and appropriate treatment are important for visual prognosis.

scholarly journals Ocular Syphilis and Human Immunodeficiency Virus Coinfection Among Syphilis Patients in North Carolina, 2014–2016

2019 ◽  
Vol 46 (2) ◽  
pp. 80-85 ◽  
Author(s):  
Anna B. Cope ◽  
Victoria L. Mobley ◽  
Sara E. Oliver ◽  
Mara Larson ◽  
Nicole Dzialowy ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
North Carolina ◽  
Ocular Syphilis ◽  
Immunodeficiency Virus

scholarly journals Mother-child transmission of Chagas disease: could coinfection with human immunodeficiency virus increase the risk?

2009 ◽  
Vol 42 (2) ◽  
pp. 107-109 ◽  
Author(s):  
Pablo Gustavo Scapellato ◽  
Edgardo Gabriel Bottaro ◽  
María Teresa Rodríguez-Brieschke
Keyword(s):  
Human Immunodeficiency Virus ◽  
Trypanosoma Cruzi ◽  
Chagas Disease ◽  
Vertical Transmission ◽  
Disease Transmission ◽  
Transmission Rate ◽  
Buffy Coat ◽  
Child Transmission ◽  
Serological Tests ◽  
Immunodeficiency Virus

A study was conducted on all newborns from mothers with Chagas disease who were attended at Hospital Donación F. Santojanni between January 1, 2001, and August 31, 2007. Each child was investigated for the presence of Trypanosoma cruzi parasitemia through direct examination of blood under the microscope using the buffy coat method on three occasions during the first six months of life. Serological tests were then performed. Ninety-four children born to mothers infected with Trypanosoma cruzi were attended over the study period. Three of these children were born to mothers coinfected with the human immunodeficiency virus. Vertical transmission of Chagas disease was diagnosed in 13 children, in all cases by identifying parasitemia. The overall Chagas disease transmission rate was 13.8% (13/94). It was 100% (3/3) among the children born to mothers with HIV infection and 10.9% (10/91) among children born to mothers without HIV [Difference = 0.89; CI95 = 0.82-0.95; p = 0.0021]. We concluded that coinfection with HIV could increase the risk of vertical transmission of Chagas disease.

scholarly journals Socio-demographic and epidemiological characteristics associated with human immunodeficiency virus type I (HIV-1) infection in HIV-1-explosed but uninfected individuals, and in HIV-1-infected patients from a southern brasilian population

2005 ◽  
Vol 47 (5) ◽  
pp. 239-246 ◽  
Author(s):  
Edna Maria Vissoci Reiche ◽  
Ana Maria Bonametti ◽  
Maria Angélica Ehara Watanabe ◽  
Helena Kaminami Morimoto ◽  
Arilson Akira Morimoto ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Human Immunodeficiency Virus Type ◽  
Virus Type ◽  
Screening Tests ◽  
Type I ◽  
Serological Tests ◽  
Asymptomatic Patients ◽  
Immunodeficiency Virus ◽  
Epidemiological Characteristics ◽  
Hiv 1

The ability to control human immunodeficiency virus type 1 (HIV-1) infection and progression of the disease is regulated by host and viral factors. This cross-sectional study describes the socio-demographic and epidemiological characteristics associated with HIV-1 infection in 1,061 subjects attended in Londrina and region, south of Brazil: 136 healthy individuals (Group 1), 147 HIV-1-exposed but uninfected individuals (Group 2), 161 HIV-1-infected asymptomatic patients (Group 3), and 617 patients with AIDS (Group 4). Data were obtained by a standardized questionnaire and serological tests. The age of the individuals ranged from 15.1 to 79.5 years, 54.0% and 56.1% of the Groups 3 and 4 patients, respectively, were men. The major features of groups 2, 3, and 4 were a predominance of education level up to secondary school (55.8%, 60.2% and 62.4%, respectively), sexual route of exposure (88.4%, 87.0% and 82.0%, respectively), heterosexual behavior (91.8%, 75.2% and 83.7%, respectively), and previous sexually transmitted diseases (20.4%, 32.5%, and 38.1%, respectively). The patients with AIDS showed the highest rates of seropositivity for syphilis (25.6%), of anti-HCV (22.3%), and anti-HTLV I/II obtained by two serological screening tests (6.2% and 6.8%, respectively). The results documenting the predominant characteristics for HIV-1 infection among residents of Londrina and region, could be useful for the improvement of current HIV-1 prevention, monitoring and therapeutic programs targeted at this population.

Human Immunodeficiency Virus and Artificial Feeding

PEDIATRICS ◽  
1989 ◽  
Vol 83 (5) ◽  
pp. 804-804
Author(s):  
STANLEY A. PLOTKIN
Keyword(s):  
United States ◽  
Human Immunodeficiency Virus ◽  
Developing Countries ◽  
Breast Milk ◽  
Infection Control ◽  
Hiv Infection ◽  
Developed Countries ◽  
The United States ◽  
Artificial Feeding ◽  
Immunodeficiency Virus

Dr Halsey has brought to my attention that a sentence in the human immunodeficiency virus (HIV) infection control statement (AAP News, September 1988) and perinatal statement (Pediatrics 1988;82:941-944) might be misinterpreted as advocating artificial feeding for HP/-infected infants in developing countries. It was our intention to advocate the use of artificial feeding by HIV-infected mothers only in the United States and other developed countries where safe water and hygienic practices are the norm. In other countries, the advantages of breast milk outweigh the possible risk of transmission to the newborn.

scholarly journals Moth-Eaten Essential Syphilitic Alopecia in Human Immunodeficiency Virus-Positive Patient: A Case Report

2021 ◽  
Vol 6 (5) ◽  
pp. 01-03
Author(s):  
Satiti Pudjiati
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hair Loss ◽  
Serological Test ◽  
Secondary Syphilis ◽  
Penicillin G ◽  
Serological Tests ◽  
Immunodeficiency Virus ◽  
High Risk Sexual Behaviour ◽  
Risk Sexual Behaviour ◽  
Unclear Etiology

Hair loss is rare to be reported as sole manifestation of secondary syphilis. Syphilitic alopecia consists of symptomatic syphilitic alopecia that presents with other secondary syphilis manifestation, and essential syphilitic alopecia which can be patchy ("moth-eaten" type), diffuse, or combination without other manifestations of secondary syphilis. Here we report a case of secondary syphilis in patient with Human Immunodeficiency Virus (HIV) that present with moth-eaten alopecia as a sole manifestation. A 35-year-old male with HIV complained hair loss on his scalp and eyebrows. Physical examination showed non scarring moth-eaten alopecia on his scalp and lossof lateral third of his eyebrows without other lesions. Serological test for syphilis was positive. He was treated with 2.4 millions unit of benzathine penicillin G (BPG), single dose intramuscular injection. Six months after injection, patient showed clinical and serological improvement. Syphilitic alopecia cannot be ruled out in patients with non scarring hair loss with unclear etiology. Serological tests are recommended especially for patients with history of high risk sexual behaviour.

Human Immunodeficiency Virus Seropositivity and Early Syphilis Stage Associated With Ocular Syphilis Diagnosis: A Case-control Study in British Columbia, Canada, 2010–2018

2019 ◽  
Vol 71 (2) ◽  
pp. 259-266
Author(s):  
Hasan Hamze ◽  
Venessa Ryan ◽  
Emma Cumming ◽  
Christine Lukac ◽  
Jason Wong ◽  
...  
Keyword(s):  
British Columbia ◽  
Human Immunodeficiency Virus ◽  
Case Control Study ◽  
Case Control ◽  
Ocular Syphilis ◽  
Early Syphilis ◽  
Immunodeficiency Virus ◽  
Hiv Serostatus ◽  
Sex With Men ◽  
Control Study

Abstract Background The incidence of syphilis has been increasing worldwide in the last 20 years, disproportionately impacting those living with human immunodeficiency virus (HIV). Alongside this increase, several jurisdictions have reported increasing incidences of syphilis-related complications, including ocular syphilis. We sought to characterize ocular syphilis cases in British Columbia (BC), Canada. Methods This case-control study compared ocular syphilis cases, matched (1:4) to syphilis controls, that were diagnosed in BC between January 2010 and December 2018. Multivariable logistic regression was used to identify potential correlates of ocular syphilis, where variables were included in the final model if significant (P ≤ .05). Results During the study period, there were 6716 syphilis diagnoses, including 66 (0.98%) ocular syphilis cases. The median age of cases was 49.5 years (interquartile range 39–59). Most (87.8%) patients were male, where 54.6% identified as men who have sex with men. The most common ophthalmologic diagnosis was panuveitis (42.4%). Of ocular syphilis patients, 48.5% were living with HIV at the time of their syphilis diagnosis, compared to 26.4% of controls (P = .001). The proportion of syphilis cases with ocular syphilis increased from 0.48% in 2010 to 0.83% in 2018. The final multivariable model demonstrated correlates between ocular syphilis and early syphilis stage, including primary/secondary (odds ratio [OR] 4.96, 95% confidence interval [CI] 1.86–13.24) and early latent (OR 4.29, 95% CI 1.62–11.34) stages, and HIV serostatus (OR 2.16, 95% CI 1.14–4.09). Conclusions Ocular syphilis increased over the study period, both in absolute numbers and as a proportion of all syphilis cases, a finding consistent with other jurisdictions. These findings highlight the importance of vigilance for ocular syphilis, to avoid diagnostic and treatment delays.

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