Panuveitis as a manifestation of ocular syphilis leading to HIV diagnosis

ABSTRACT

Syphilis is a rare cause of panuveitis. We present the case of a 33-year-old man who presented with diminution of vision of three months duration in his left eye [OS], without any other systemic illness. Ophthalmic examination showed features of pauveitis with dense vitreous exudates, disc pallor and sheathing of vessels on fundoscopy. A diagnosis of probable endogenous endophthalmitis was made and vitreous tap performed. Vitreous biopsy showed no growth of fungus or bacteria. Rapid plasma reagin [RPR] and Treponema pallidum hemagglutination [TPHA] test were positive. Enzyme-Linked lmmuno Sorbent Assay [ELISA] and Western Blot test were then performed, which revealed concurrent HTV infection. The patient improved dramatically with intravenous penicillin therapy HIV positive patients may present with panuveitis secondary to ocular syphilis, as the only presenting feature in HIV positive patient in absence of any other systemic features