原创力文档an immunocompetent migrant presenting with neurosyphilis with an unusual unilateral papillitis a case report神经梅毒的免疫活性的移民提供一个不同寻常的单侧视神经乳头炎病例报告.pdfVIP
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an immunocompetent migrant presenting with neurosyphilis with an unusual unilateral papillitis a case report神经梅毒的免疫活性的移民提供一个不同寻常的单侧视神经乳头炎病例报告
Turchetti et al. European Journal of Medical Research 2012, 17:3
/content/17/1/3 EUROPEAN JOURNAL
OF MEDICAL RESEARCH
CASE REPORT Open Access
An immunocompetent migrant presenting with
neurosyphilis with an unusual unilateral papillitis:
a case report
1 2 2 1 1*
Paolo Turchetti , Fernanda Pacella , Elena Pacella , Concetta Mirisola and Ilaria Uccella
Abstract
Unilateral papillitis caused by Treponema pallidum was found in an immunocompetent homosexual patient with
severe vision loss who had received previous antibiotics treatment. Syphilis-related ocular manifestation is more
common in the early stages of the disease and it can be associated with a central nervous system localization. In
this patient, neurosyphilis was diagnosed on the basis of clinical and laboratory findings. Optical examination
revealed unilateral papillitis in the left eye and no relative afferent pupillary defects. The patient underwent visual
field examinations with conventional perimetry using the 30-2 program of the Humphrey Visual Field Analyzer,
which indicated a blind spot enlargement in the left eye. Optical coherence tomography, visual evoked potentials
(VEP), and fluorescein angiograms revealed inflammation of the optic nerve head with edematous and blurred
margins. A reactive T. pallidum hemagglutination assay with low rapid plasma reagin (RPR) serum titer was
performed; an HIV antibody test and MRI of the orbits and head with contrast gave negative results. Resolution of
the ocular inflammation after intravenous penicillin treatment was obtained. The reported cas
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