[Two cases of syphilitic uveitis and HIV]. / Dos casos de uveítis sifilítica y VIH.

CASE REPORTS: Case 1: HIV+ patient presenting unilateral panuveitis. Physical examination showed secondary signs of syphilis. The condition was treated with an excellent result. Case 2: Patient with bilateral panuveitis having received different treatments in another centre for a period of months. In the anamnesis we detected risk factors for AIDS and ordered appropriate tests to be done, with the patient resulting positive for HIV and syphilis. We proceeded to treat. DISCUSSION: The incidence of syphilis is rising in developed countries and its manifestations in HIV+ patients can be atypical. An adequate clinical history is fundamental for an early diagnosis. Macrolides can be an alternative treatment in penicillin-allergic patients.

Dos casos de uveítis sifilítica y VIH / Two cases of syphilitic uveitis and HIV

Casos clínicos: Caso 1: paciente VIH+ que presenta una panuveítis unilateral. La exploración física muestra signos de sífilis secundaria. Se trata con excelente respuesta. Caso 2: Paciente con panuveítis bilateral que ha recibido varios tratamientos durante meses en otro centro. En la anamnesis se detectaron factores de riesgo para SIDA, se realizan serologías que son positivas para VIH y sífilis y se procede al tratamiento. Discusión: La sífilis está aumentando en los países desarrollados y sus manifestaciones en pacientes VIH+ pueden ser atípicas. Una historia clínica adecuada es fundamental para un diagnóstico precoz. Los macrólidos pueden ser una alternativa en pacientes alérgicos a penicilina

Case reports: Case 1: HIV+ patient presenting unilateral panuveitis. Physical examination showed secondary signs of syphilis. The condition was treated with an excellent result. Case 2: Patient with bilateral panuveitis having received different treatments in another centre for a period of months. In the anamnesis we detected risk factors for AIDS and ordered appropriate tests to be done, with the patient resulting positive for HIV and syphilis. We proceeded to treat. Discussion: The incidence of syphilis is rising in developed countries and its manifestations in HIV+ patients can be atypical. An adequate clinical history is fundamental for an early diagnosis. Macrolides can be an alternative treatment in penicillin-allergic patients (Arch Soc Esp Oftalmol 2008; 83: 197-200)

[Three cases of early neurosyphilis in HIV patients]. / Tres casos de neurosífilis precoz en pacientes infectados por VIH.

In spite of the relative control of the disease in the late 20th century, syphilis, like other sexually transmitted diseases, has undergone a strong resurgence in recent years in the large urban centers of Europe and the US. Many patients with syphilis are also HIV+. The association between the two diseases may modify the clinical evolution of syphilis and increase the incidence of neurological disorders. We discuss the cases of three patients diagnosed with both diseases last year, with neurological presentation of syphilis occurring early and ophthalmic or cochlear vestibular involvement. This recent outbreak of syphilis seems to lead to an increase in the number of atypical cases presenting in our daily practice, where we must be prepared for early diagnosis and treatment.

Tres casos de neurosífilis precoz en pacientes infectados por VIH / Three cases of early neurosyphilis in HIV patients

A pesar del relativo control de la enfermedad durante la segunda mitad del siglo XX, la sífilis, como otras enfermedades de transmisión sexual, ha reaparecido con fuerza durante los últimos años en grandes focos urbanos de Europa y Norteamérica. Un porcentaje importante de pacientes con sífilis sufren además infección por virus de la inmunodeficiencia humana (VIH). La asociación de ambas enfermedades puede modificar la evolución clínica de la infección luética y aumentar la incidencia de eventos neurológicos. Presentamos los casos de tres pacientes diagnosticados durante este último año en los que ambas enfermedades coexisten, manifestándose la sífilis con clínica neurológica precoz y afectación oftálmica o cócleo-vestibular. Este reciente brote de sífilis parece traducirse en un aumento de los casos atípicos en nuestra práctica clínica diaria que debemos estar preparados para reconocer y tratar de forma precoz

In spite of the relative control of the disease in the late 20th century, syphilis, like other sexually transmitted diseases, has undergone a strong resurgence in recent years in the large urban centers of Europe and the US. Many patients with syphilis are also HIV+. The association between the two diseases may modify the clinical evolution of syphilis and increase the incidence of neurological disorders. We discuss the cases of three patients diagnosed with both diseases last year, with neurological presentation of syphilis occurring early and ophthalmic or cochlear vestibular involvement. This recent outbreak of syphilis seems to lead to an increase in the number of atypical cases presenting in our daily practice, where we must be prepared for early diagnosis and treatment