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Between December 2014 and March 2015, 12 cases of ocular syphilis were reported from two major cities, San Francisco and Seattle. Subsequent case finding indicated more than 200 cases reported over the past 2 years from 20 states. The majority of cases have been among HIV-infected MSM; a few cases have occurred among HIV-uninfected persons including heterosexual men and women. Several of the cases have resulted in significant sequelae including blindness.
Ocular syphilis can involve almost any eye structure, but posterior uveitis and panuveitis are the most common. Additional manifestations may include anterior uveitis, optic neuropathy, retinal vasculitis and interstitial keratitis. Ocular syphilis may lead to decreased visual acuity including permanent blindness. Ocular syphilis can be associated with neurosyphilis. Both ocular syphilis and neurosyphilis can occur at any stage of syphilis, including primary and secondary syphilis. While previous research supports evidence of neuropathogenic strains of syphilis, it remains unknown if some Treponema pallidum strains have a greater likelihood of causing ocular infections.
Pre-antibiotic clinical samples (whole blood, primary lesions and moist secondary lesions, CSF or ocular fluid) should be saved and stored at -80°C immediately upon collection for molecular typing.
If you need advice from CDC regarding the clinical management of ocular syphilis, contact Dr. Kimberly Workowski at 404-639-1898 or firstname.lastname@example.org. If you are planning on collecting clinical specimens for molecular typing and need assistance with the collection procedure or shipment of samples, please contact Dr. Allan Pillay at 404-639-2140 or email@example.com.
Content source: Division of STD Prevention (/std/dstdp), National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (/nchhstp), Centers for Disease Control and Prevention(/)