Uveitis: A presenting sign of both secondary syphilis and HIV Infection

ABSTRACT

Uveitis is a well-documented presentation of syphilis with or without concomitant HIV infection1,2. Syphilitic uveitis occurs most frequently during secondary and tertiary phases of the infection and its prevalence has declined in tandem with the decline in syphilis prevalence during the early phase of the HIV epidemic. However, during the past 5 years, there has been a resurgence of syphilis and an increased number of patients with ocular syphilis has been reported3,4. Early diagnosis of ocular syphilis which is highly amenable to simple antibiotic treatment can prevent blindness. Unfortunately, the ocular manifestations of syphilis are indistinguishable from that of other causes. Hence, a high index of suspicion is necessary to diagnose syphilitic uveitis. Awareness and recognition of concurrent syphilitic skin involvement, often mistaken for psoriasis, can aid in the diagnosis. We describe a patient whose ocular syphilis was diagnosed and treated promptly because of the presence of a palmoplantar rash.