Images of Infectious Diseases
28F SLE on MTX
CC chest pain, vaginal DC
Rx pred for lupus
2 mo: fatigue, pruritic rash, visual floaters Rx pred
1 mo: blurred vision. PE iritis / chorioretinitis. Rx pred
Now b/l vision loss. PE panuveitis + chorioretinitis
DDx? #MayoIDQ
28F SLE on MTX
CC chest pain, vaginal DC
Rx pred for lupus
2 mo: fatigue, pruritic rash, visual floaters Rx pred
1 mo: blurred vision. PE iritis / chorioretinitis. Rx pred
Now b/l vision loss. PE panuveitis + chorioretinitis
DDx? #MayoIDQ
2/
28F HIV/HBV/HCV(-) SLE on MTX w chronic pain Rx as flare, vaginal discharge due to BV Rx metro (negative GC/chlamydia), skin rash x 2 w and progressive vision loss (photo). CXR clear. Indiana / no foreign travel. No animal exposures.
What is most likely diagnostic test?
28F HIV/HBV/HCV(-) SLE on MTX w chronic pain Rx as flare, vaginal discharge due to BV Rx metro (negative GC/chlamydia), skin rash x 2 w and progressive vision loss (photo). CXR clear. Indiana / no foreign travel. No animal exposures.
What is most likely diagnostic test?
3/
Case diagnosis: bilateral ocular syphilis with neurosyphilis
RPR 1:512
Syphilis antibody with reflex: positive
CSF VDRL 1:1
Rx: IV penicillin
Case diagnosis: bilateral ocular syphilis with neurosyphilis
RPR 1:512
Syphilis antibody with reflex: positive
CSF VDRL 1:1
Rx: IV penicillin
4/
We have previously highlighted a case series of ocular syphilis reported by our fellows
Bilateral eye involvement, pan-uveitis, and CNS involvement are common!
@cristinacorsini @JohnRaymondGo1 @dwchallener
We have previously highlighted a case series of ocular syphilis reported by our fellows
Bilateral eye involvement, pan-uveitis, and CNS involvement are common!
@cristinacorsini @JohnRaymondGo1 @dwchallener
https://twitter.com/mayoclinicinfd/status/1345705059766710275?s=21
5/
Review of 127 HIV+ and HIV- patients with ocular syphilis in 214 eyes
Uveitis is most common presentation
“Involvements in 214 eyes were anterior (6.1%), intermediate (8.4%), posterior (76.2%) and pan- (8.4%) uveitis, and scleritis (0.9%).”
nature.com/articles/s4159…
Review of 127 HIV+ and HIV- patients with ocular syphilis in 214 eyes
Uveitis is most common presentation
“Involvements in 214 eyes were anterior (6.1%), intermediate (8.4%), posterior (76.2%) and pan- (8.4%) uveitis, and scleritis (0.9%).”
nature.com/articles/s4159…
6/
Complications of ocular #syphilis
“cataract; ocular hypertension or glaucoma; epiretinal membrane; optic nerve atrophy; and rhegmatogenous retinal detachment”
nature.com/articles/s4159…
Complications of ocular #syphilis
“cataract; ocular hypertension or glaucoma; epiretinal membrane; optic nerve atrophy; and rhegmatogenous retinal detachment”
nature.com/articles/s4159…
7/
In most case series of ocular syphilis, CNS involvement is common (especially those with posterior uveitis / chorioretinitis)
“lumbar puncture should be a routine investigation for all patients diagnosed with ocular #syphilis”
In most case series of ocular syphilis, CNS involvement is common (especially those with posterior uveitis / chorioretinitis)
“lumbar puncture should be a routine investigation for all patients diagnosed with ocular #syphilis”
8/
Here is a link of brief review of Infectious retinitis with accompanying photos
Here is a link of brief review of Infectious retinitis with accompanying photos
https://twitter.com/mayoclinicinfd/status/1347955726191386634?s=21
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