Abstract
While the prevalence of syphilis had seen a significant decrease in the post-antibiotic era, it can still present in immunocompromised patients. While it is rare for immunocompetent patients to present with advanced stages of Syphilis, prompt recognition and diagnosis is imperative to prevent serious complications. We present the case of a 52 year old immunocompetent female who was diagnosed with syphilis 30 years ago who presented with vague symptoms including a rash, blurred vision, and headache and was diagnosed with early neurosyphilis.
Highlights
Syphilis is caused by the spirochete bacterium, Treponema pallidum
We present the case of a 52 year old immunocompetent female who was diagnosed with syphilis 30 years ago who presented with vague symptoms including a rash, blurred vision, and headache and was diagnosed with early neurosyphilis
A 52 year old female with underlying methamphetamine use, human papillomavirus (HPV), and history of syphilis presented to the emergency department (ED) with symptoms of right eye pain, redness, and blurry vision for 10 days
Summary
Syphilis is caused by the spirochete bacterium, Treponema pallidum. Syphilis is most commonly spread via sexual contact, but can be transmissible through blood contact/transfusions, mother to fetus in utero, and even skin breaks in contact with infectious lesions. The stages of syphilis are primary, secondary, latent, and tertiary. Primary syphilis presents weeks to months after infection with painless, ulcerative lesions (chancre) in the genital area [1]. Approximately 25% of individuals will develop subsequent secondary syphilis 1 to 4 months after infection. This stage represents a systemic infection and can present with various findings. The latent stage of syphilis refers to when an individual is shown to have Treponema pallidum on serologic testing, but is asymptomatic. About 25-40% of untreated individuals will develop tertiary (late) syphilis ranging from 1 to 30 years after infection [3]. We present the case of a 52 year old immunocompetent female who was diagnosed with syphilis 30 years ago who presented with vague symptoms including a rash, blurred vision, and headache and was diagnosed with early neurosyphilis
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