Journal of Postgraduate Medicine
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Neurosyphilis in a young man having HIV infection, blurring of vision and skin rash

 Department of Medicine, Cagayan Valley Medical Center, Tuguegarao City, Cagayan, Philippines

Correspondence Address:
JV Pagaddu,
Department of Medicine, Cagayan Valley Medical Center, Tuguegarao City, Cagayan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jpgm.jpgm_484_22

PMID: 37171413

We report a 22-year-old homosexual man, a known case of HIV-1 infection but non-compliant to medications, who presented with a 5-month history of progressive painless non-pruritic coin-shaped skin lesions and recent gradual bilateral blurring of vision. His history divulged a primary syphilitic event 1 year prior to the present clinical manifestations. Investigation led to the diagnosis of neurosyphilis with ocular involvement with concurrent signs of secondary syphilis. Treatment with aqueous crystalline penicillin G, ophthalmic steroid and tropicamide drops, and topical emollients resulted in significant clinical improvement of ocular symptoms and skin lesions. The diagnosis of neurosyphilis requires a high degree of clinical suspicion and should be included in the differential diagnosis of unexplained ocular symptoms, particularly in men who have sex with men and HIV-infected patients. This is necessary for the early diagnosis, appropriate management, and good outcome of these patients.

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Online since 12th February '04
2004 - Journal of Postgraduate Medicine
Official Publication of the Staff Society of the Seth GS Medical College and KEM Hospital, Mumbai, India
Published by Wolters Kluwer - Medknow