Uveitis, syphilis and AIDS

Abstract

The authors report on a 55 year-old man,with
treated primary syphilis in his twenties.Since then
four further episodes were described,the last one,adequately treated,two years ago.A red eye took
him to the outpatient ophtalmologic clinic where a
diagnosis of panuveitis and syphilitic roseola was
made,and his laboratorial evaluation disclosed
Venereal Disease Reseach Laboratory (VDRL)
positive; Fluorescent Treponemal Antibody
Absorbed (FTHA) Test positive; Human
Imunodeficiency Virus (HIV) positive.
He was admitted for cerebral spinal fluid
examination,which showed pleocitosis,increased
proteins, VDRL negative, TPHA positive, FTA-ABS
positive, compatible with syphilitic envolvement of
Central Nervous System.
Neurosyphilis diagnosis in dually infected patients
with syphilis and HIV is difficult and complex,
because it is based on serological tests that don’t
follow the usual pattern.
Therapy is also controversial,because there are
several reported neurological recurrencies after
conventional treatment.A close follow up of these
patients is recommended.