A Case of Acute Interstitial Keratitis in a Patient with Acquired Syphilis.
10.3341/jkos.2017.58.2.226
- Author:
Tae Jin KIM
1
;
Han Gyul YOON
;
Jae Woong KOH
Author Information
1. Department of Ophthalmology, Chosun University School of Medicine, Gwangju, Korea. ophkoh@hanmail.net
- Publication Type:Case Report
- Keywords:
Acquired syphilis;
Interstitial keratitis;
Ocular syphilis;
Treponema pallidum
- MeSH:
Anti-Bacterial Agents;
Cornea;
Diagnosis;
Doxycycline;
Edema;
Female;
Fluorescent Treponemal Antibody-Absorption Test;
Humans;
Immunoglobulin G;
Keratitis*;
Patient Rights;
Serologic Tests;
Sexually Transmitted Diseases;
Slit Lamp;
Steroids;
Syphilis*;
Syphilis, Latent;
Treponema pallidum;
Vision Disorders;
Visual Acuity;
Young Adult
- From:Journal of the Korean Ophthalmological Society
2017;58(2):226-229
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To report a case of acute interstitial keratitis as the first clinical sign in a patient with latent syphilis. CASE SUMMARY: A 23-year-old female presented with visual impairment and discomfort in her right eye that developed 3 days earlier. The visual acuity in the right eye was 20/200 and corrected to 20/100, and slit lamp examination showed round sub-epithelial opacification in the central cornea with stromal edema and neovascularization on the cornea of the right eye. Whole body tests including serological tests were performed. Under the suspicion of acute interstitial keratitis, topical antibiotics and steroids were applied 4 times a day initially. Serological tests were reactive for venereal disease research laboratory test (VDRL). Under the suspicion of acute interstitial keratitis due to syphilis, fluorescent treponemal antibody absorption test IgM/IgG (FTA-ABS IgM/IgG) was performed; a positive result for FTA-ABS IgG led to diagnosis of acute interstitial keratitis with latent syphilis. During treatment, systemic doxycycline 200 mg for 4 weeks with topical antibiotics and steroids were administered, the opacity and edema of the cornea regressed after 2 weeks of treatment, and visual acuity in the patient's right eye improved to 20/20. CONCLUSIONS: We report an unusual case of acute interstitial keratitis as the first clinical manifestation of latent syphilis in an immunocompetent patient.
