Bilateral Syphylitic Chorioretinitis in a 33-year-old Pervitin User

Authors: D. Darsová;  D. Dotřelová
Authors‘ workplace: Oční klinika dětí a dospělých 2. LF UK a FN v Motole, Praha
Published in: Cesk Slov Neurol N 2011; 74/107(2): 197-200
Category: Case Report


Neurochorioretinitis is an inflammatory process affecting the optic nerve, choroid and retina. Neurochoroiditis is the least frequent type of optic neuritis. It is most often associated with viral infections and cat-scratch fever, less common with syphilis and Lyme disease. The authors describe the clinical course of neurochoroiditis in a 33-year-old, otherwise healthy woman who was referred to our clinic with acute decreased central visual acuity (6/60) in the right eye. She had complained of headache, low-grade fever, hoarseness and generalized skin rash four months previously. However, her symptoms had resolved spontaneously. She reported pervitin (methyl amphetamine) abuse within the previous year. Ophthalmic examination disclosed bilateral neurochorioretinitis, perivasculitis and a dusty vitreous haze. Fluorescein angiography revealed vasculitis. Positive direct and indirect treponemal tests confirmed a diagnosis of syphylis. Early recognition of the clinical manifestation of syphilis and prompt commencement of treatment with crystalline penicillin improved functional and anatomical changes in both eyes within four weeks. This data should may helpful in the exact diagnosis of neurosyphilis. The case report illustrates syphilis diagnosed by an ophthalmologist in terms of the atypical form of posterior uveitis.

Key words:
atypical form of posterior uveitis – neurochorioretinitis – neurosyphilis – syphilis


1. Avenel G, Goëb V, Abboud P, Ait-Abdesselam T, Vittecoq O. Atypical forms of syphilis: two cases. Joint Bone Spine 2009; 76(3): 293–295.

2. Margo C, Hamed L. Ocular syphilis. Surv Ophthalmol 1992; 37(3): 203–220.

3. Timmermans M, Carr J. Neurosyphilis in the modern era. J Neurol Neurosurg Psychiatry 2004; 75(12): 1727–1730.

4. Dourmishev L, Dourmishev A. Syphilis: uncommon presentations in adults. Clin Dermatol 2005; 23(6): 555–564.

5. Römer P. Lehrbuch der Augenheilkunde in der Form klinischer Besprechungen. Retinitis syphilitica, leukaemica. 2nd ed. Wien: Urban, Schwarzenberg 1913: 306.

6. Tait M, Yound Z, Campbell J. Syphilitic chorio­retinitis. In: Ferris JD. Essential Medical Ophthalmology: a problem oriented approach. 1st ed. Italy: ­Butterworth-Heinemann 2001: 65–66.

7. Kuo I, Kapusta M, Rao N. Vitritis as the primary ­manifestation of ocular syphilis in patients with HIV infection. Am J Ophthalmol 1997; 125(3): 306–311.

8. Aldave A, King J, Cunningham E jr. Ocular syphilis. Curr Opin Ophthalmol 2001; 12(6): 433–441.

9. Zákoucká H, Polanecký V, Kastánková V. Syphilis and gonorrhoea in the Czech Republic. Eurosurveillance 2004; 9(12): 18–22.

Paediatric neurology Neurosurgery Neurology
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