Acute syphilitic chorioretinitis after a missed primary diagnosis: a case report
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BioMed Central
Open Access
Case report
Acute syphilitic chorioretinitis after a missed primary diagnosis: a case report Claudia Handtrack1, Harald Knorr2, Kerstin U Amann3, Christoph Schoerner4, Karl F Hilgers1 and Walter Geißdörfer*4 Address: 1Department of Nephrology and Hypertension, Krankenhausstraße 12, 91054 Erlangen, Germany, 2Department of Ophthalmology, Schwabachanlage 6, 91054 Erlangen, Germany, 3Institut of Pathology, Krankenhausstraße 8, 91054 Erlangen, Germany and 4Institut of Clinical Microbiology, Immunology and Hygiene, Wasserturmstraße 3, 91054 Erlangen, Germany Email: Claudia Handtrack - [email protected]; Harald Knorr - [email protected]; Kerstin U Amann - [email protected]; Christoph Schoerner - [email protected]; Karl F Hilgers - [email protected]; Walter Geißdörfer* - [email protected] * Corresponding author
Published: 1 February 2008 Journal of Medical Case Reports 2008, 2:33
doi:10.1186/1752-1947-2-33
Received: 13 July 2007 Accepted: 1 February 2008
This article is available from: http://www.jmedicalcasereports.com/content/2/1/33 © 2008 Handtrack et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Introduction: Syphilis is well known as an infectious disease which can present with a large variety of symptoms. Clinical diagnosis can be difficult and may be complicated in modern medicine by immunosuppressive treatment and possible side effects of medication. Case presentation: We describe a rare case of placoid chorioretinitis due to Treponema pallidum which developed after the primary symptom of proteinuria was not recognized as a rare manifestation of syphilis. Diagnosis of syphilitic chorioretinitis and/or endophthalmitis was made by broad range amplification of the bacterial 16S ribosomal RNA gene obtained from vitreous after diagnostic vitrectomy. Conclusion: This case shows that clinicians should be alert in patients with proteinuria and chorioretinitis as they can represent rare manifestations of syphilis. Syphilis should be in the differential diagnosis of any unknown symptom and in the presumed side effects of medication.
Introduction Primary syphilis is characterized by a single cutaneous or mucosal lesion (hard chancre) at the site of infection, which is self-healing, but frequently followed by the secondary, disseminated stage with a variety of possible symptoms, including maculopapular rashes, mucous patches in the mouth, genital condylomata, alopecia, malaise with fever, and, in less than one percent of the cases, renal or ocular manifestations [1]. Laboratory diagnosis of syphilis by serological tests is well established, highly sensitive and specific.
Within the last decade a rising inci
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