Abstract
BackgroundThe purpose of this report is to present a case of optic and vestibulocochlear neuropathy as a manifestation of concurrent HIV and syphilis coinfection. This is an interventional case report of a 37-year-old man who complained of blurry central vision in his left eye and hearing loss in his left ear over the past 2 weeks.FindingsVisual acuity was 20/20 in both eyes, and the anterior segment was normal in both eyes without relative afferent pupillary defect. Fundoscopy revealed swelling of the left optic disc. Optic coherence tomography and the Heidelberg retina tomograph confirmed and quantified the oedema of the left optic disc. An audiometry showed a left sensorineural deafness. Serological examinations disclosed confirmed HIV and syphilis infection. Magnetic resonance imaging of the brain showed no abnormalities. Properly treated with intravenous penicillin, the lesions resolved.ConclusionsSimultaneous optic and auditive involvement can be the first manifestation of syphilitic and HIV coinfection. To our knowledge, this report is the first to describe the rare occurrence of syphilitic optic neuritis and ipsilateral affectation of the vestibulocochlear nerve.
Highlights
The purpose of this report is to present a case of optic and vestibulocochlear neuropathy as a manifestation of concurrent HIV and syphilis coinfection
This report is the first to describe the rare occurrence of syphilitic optic neuritis and ipsilateral affectation of the vestibulocochlear nerve
The incidence of syphilis continues to rise in the USA and Europe, and it is estimated that around 20% of patients with syphilis in the USA have HIV infection [1-3]
Summary
The purpose of this report is to present a case of optic and vestibulocochlear neuropathy as a manifestation of concurrent HIV and syphilis coinfection. Conclusions: Simultaneous optic and auditive involvement can be the first manifestation of syphilitic and HIV coinfection. The observation of optic nerve abnormalities in an ophthalmological examination in a patient with syphilis is highly suggestive of central nervous system (CNS) involvement and should be considered synonymous with neurosyphilis [4,5].
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