Unilateral papillitis and exudative retinal detachment: an unusual manifestation of ocular syphilis

The common and typical posterior segment manifestations of ocular syphilis are choroiditis, retinitis and retinal vasculitis but since syphilis has a tendency to masquerade any uveitis entity it should be ruled out in all cases of posterior uveitis. We describe an uncommon case of unilateral papillitis and exudative retinal detachment where syphilis was initially a remote possibility. Systemic steroids seemed to make the clinical situation worse. Then a single positive serological test for syphilis [TPABS] suggested ocular syphilis. Complete resolution was obtained with an anti-syphilis antibiotic regimen