Título / Title

OCULAR SYPHILIS, THE RETURN OF AN IMPORTANT DISEASE AND ITS THERAPEUTIC OPTIONS - CASE REPORT

Introdução / Purpose

In Syphilis, optic neuropathy, posterior chorioretinitis and necrotizing retinitis are forms to be found. In cases of optic neuritis, the patient may complain of loss in visual acuity, dyschromatopsia, loss of sensitivity to light and contrast, and visual field defects. Treatment with penicillin is the choice. Systemic corticosteroids can be used in cases of severe uveitis, scleritis or optic neuritis. Prolonged follow-up is recommended due to the risk of recurrence. We report a case of ocular syphilis and its successful treatment with parenteral Ceftriaxone for 14 days.

Material e Método / Methods

Patient E.A.S., 45 years old, male, with retrobulbar neuritis and bilateral syphilitic placoid choroidopathy was evaluated and prescribed Ceftriaxone 2g/day for 14 days, followed by the use of Penicillin G Benzathine 2.4 mi IU IM, for 3 consecutive weeks.

Resultados / Results

One month after the initial treatment, the patient evolved with improvement in papillary blurring and BCVA of OD: 20/100 e OS: 20/80 turned to 20/25 in both eyes.

Discussão e Conclusões / Conclusion

Cases of ocular syphilis presenting with optic neuritis or any uveitis are considered neurosyphilis and the treatment of choice is Penicillin G Crystalline for 10-14 days. In this case, the infectology team opted for Ceftriaxone, due to the availability of the medication at the service and the possibility of discontinuity of hospitalization. The increase in syphilis cases in Brazil, ophthalmologists have come to play an important role in the early diagnosis and treatment of this potentially fatal disease, since a portion of patients are more likely to complain of visual symptoms caused by syphilis than the systemic symptoms.

Palavras Chave

Retrobulbar neuritis syphilis ceftriaxone

Area

CLINICAL RETINA