Venereal Disease Research Laboratory Titer Research Articles

Characteristics of syphilis in the Dermato-Venereology Department of Bali Mandara General Hospital

Introduction: Treponema pallidum is the sexually transmitted pathogen that causes syphilis. Congenital or acquired syphilis are the two categories. In 2020, the World Health Organization (WHO) anticipates 7 million additional cases of syphilis. 76,923 new patients were reported in 2020 by the Ministry of Health of the Republic of Indonesia. There is still inadequate information about Bali's incidence or prevalence of syphilis. This study aims to describe the characteristics of syphilis patients seeking treatment at Bali Mandara Hospital's Dermato-Venereology Department between 1st January 2020 to 31st December 2022. Methods: In this descriptive cross-sectional retrospective study from 1st January 2020 to 31st December 2022, we used 56 samples from secondary data collected from the patient register book and medical records of the dermatovenereology outpatient clinic at Bali Mandara General Hospital. Data were analyzed descriptively using SPSS version 26. Results: According to the study, there were 56 syphilis patients, including 32 men (57.1%) and 24 women (42.9%). The most common age group was 25 to 44 years old, with 36 patients (64.3%), while the most common clinical stage of syphilis was early latent syphilis, with 20 patients (35.7%). Venereal Disease Research Laboratory (VDRL) titer of 1:2 was the most frequent finding, with 16 patients (28.6%). Conclusion: It may be concluded that syphilis cases at Bali Mandara General Hospital have a different description that varies according to each variable. Future studies on syphilis cases are anticipated to build on the findings of this study.

Atypical Manifestations of Syphilis: A 10-Year Retrospective Study.

Background: The incidence of syphilis has increased in high-income countries in the past few decades, especially among men who have sex with men. In the present study, we aimed to analyze the correlations between atypical syphilis manifestations and the demographic, clinical, and laboratory features of patients and to review unusual presentations of syphilis reported in the literature. Methods: We conducted a retrospective analysis of 307 patients with syphilis diagnosed between 1 January 2013 and 31 October 2023 at the sexually transmitted infection (STI) centers of the University of Genoa and University of Foggia with both typical and atypical manifestations of disease. Results: In our series, atypical manifestations were detected in 25.8% of the patients, especially in the secondary stage of the disease. Lesions with annular morphology and lesions presenting as itchy erythematous scaly plaques with a psoriasiform appearance were the most common atypical presentations of secondary syphilis. A statistical analysis revealed that homosexual orientation, syphilis reinfection, and venereal disease research laboratory (VDRL) titers > 1:32 were correlated with atypical manifestations. Conclusions: Our study demonstrates that the spectrum of syphilis manifestations, in all the stages of the disease, is wide; atypical manifestations often pose diagnostic challenges, may delay the provision of appropriate treatment, and facilitate the spread of the infection.

Secondary syphilis in a 13-year-old Indonesian girl: a social problem

Introduction: Secondary syphilis is characterized by skin and mucous eruptions, such as condyloma lata. Syphilis cases are rare in children. Several factors could influence sexually transmitted infections (STIs) in children, such as lack of knowledge of STIs, parenting, social environment, parents’ marital status, occupation, and education. We reported one social case of secondary syphilis in a 13-year-old girl. Case Presentation: We did history taking, physical, and laboratory examinations. From history taking, the patient did not know about the signs and symptoms of STIs, has bad parenting, a bad social environment, divorced parents, and parents’ low education. On physical examination, there were skin-colored papules, plaques, and nodules on the labia majora, minora, and perianal. The venereal disease research laboratory (VDRL) result was reactive. The patient was treated with single dose injection of 2.4 million international units benzathine penicillin G and was educated for signs, symptoms, and complications of STIs, and the danger of risky sexual behavior. There were improvement of the lesions 10 days after therapy, decreased of VDRL titer 4x in one month after therapy, and no longer have sexual activity. Conclusion: Social condition can cause STIs in children. The bigger scope of education programs for children is needed to prevent STIs.

An Alternative Treatment Option for Congenital Syphilis: A Case Series

ABSTRACT Newborn babies born to untreated syphilis-positive mothers need to be treated adequately and timely to prevent and cure congenital syphilis. Penicillin is one of the most robust and the most recommended drug for the same. However, in case of penicillin shortage or an adverse effect to penicillin, an alternative treatment is warranted. Injection ceftriaxone is a promising drug in case of penicillin unavailability. We present a case series in which we treated five asymptomatic newborn babies having positive venereal disease research laboratory (VDRL) titers with ceftriaxone 100 mg/kg/day in two divided doses for 10 days. The patients were cured and discharged on Day 11.

Secondary Syphilis and Human Immunodeficiency Virus (HIV) Co-infection in Men Who Have Sex with Men (MSM) with Triple Doses Benzathine Penicillin G Treatment: A Case Report

Background: World Health Organization (WHO) reported that there are 6 million new cases of syphilis worldwide per year. The incidence of syphilis in Indonesia has increased over the past few years, particularly among men who have sex with men (MSM). Purpose: To report a case of secondary syphilis with Human Immunodeficiency Virus (HIV) coinfection in MSM, thereby increasing understanding of high-risk sexual behavior among MSM. Case: A 26-year-old man with a chief complaint of rashes on both palms, soles of the feet, and face. The rashes spread with no itching, heat, or pain, which occurred two weeks ago. The patient was diagnosed with HIV in 2019. Physical examination found multiple violaceus macules with clear boundaries, 0.5–1 cm in size, covered with scales. Venereal Disease Research Laboratory (VDRL) serology titer was 1:16 and Treponema Pallidum Haemagglutination Assay (TPHA) was 1:20.480. The recent CD4 count was 440 with an undetectable HIV RNA viral load. Benzathine penicillin G 2.4 million units was given intramuscularly 3 times at 1-week intervals. The patient experienced clinical improvement and decreased VDRL and TPHA titers. Discussion: Syphilis patients with or without HIV would have similar clinical symptoms. However, syphilis patients with HIV tend to have more extensive lesions. The treatment option with three doses of benzathine penicillin G is still very effective in cases of syphilis with HIV. Conclusion: Syphilis has a higher incidence in MSM patients with extensive clinical manifestations of skin lesions. It can be observed in syphilis patients with HIV; therefore, close monitoring is needed.

Lumbar puncture for neurosyphilis investigation in asymptomatic patients with HIV-syphilis coinfection: a cross-sectional study among infectious disease specialists.

Syphilis is a major public health issue worldwide. In people living with human immunodeficiency virus (PLHIV), there are higher incidences of both syphilis and neurosyphilis. The criteria for referring PLHIV with syphilis for lumbar puncture is controversial, and the diagnosis of neurosyphilis is challenging. To describe the knowledge, attitudes, and practices of infectious disease specialists and residents in the context of care for asymptomatic HIV-syphilis coinfection using close-ended questions and case vignettes. Cross-sectional study conducted in three public health institutions in São Paulo (SP), Brazil. In this cross-sectional study, we invited infectious disease specialists and residents at three academic healthcare institutions to answer a self-completion questionnaire available online or in paper form. Of 98 participants, only 23.5% provided answers that were in line with the current Brazilian recommendation. Most participants believed that the criteria for lumbar puncture should be extended for people living with HIV with low CD4+ cell counts (52.0%); in addition, participants also believed that late latent syphilis (29.6%) and Venereal Disease Research Laboratory (VDRL) titers ≥ 1:32 (22.4%) should be conditions for lumbar puncture in PLHIV with no neurologic symptoms. This study highlights heterogeneities in the clinical management of HIV-syphilis coinfection. Most infectious disease specialists still consider syphilis stage, VDRL titers and CD4+ cell counts as important parameters when deciding which patients need lumbar puncture for investigating neurosyphilis.

Laboratory evaluation of two point-of-care test kits for the identification of infectious syphilis.

Syphilis is a sexually transmitted disease that can have atypical clinical presentations. Conventional laboratory tests to confirm the diagnosis are not rapid enough to affect clinical decision on treatment and contact tracing. Rapid point-of-care tests (POCT) can be useful for control of infectious diseases; however, no POCT for syphilis detection is currently available in Canada. The aim of this study is to evaluate two POCTs (RevealTM Rapid TP (Treponema pallidum) Antibody test and DPP® Syphilis Screen and Confirm test) for detection of infectious syphilis. One hundred serum samples with known syphilis serological status, based on treponemal and non-treponemal test results, were analysed in the laboratory with two POCTs by two independent operators in a blind fashion. Results were analysed to evaluate their ability to detect infectious syphilis. The Reveal Rapid TP Antibody POCT showed an overall sensitivity of 95.0% and a specificity of 83.3%, while the DPP Syphilis Screen and Confirm POCT showed a sensitivity of 87.5% and a specificity of 98.3%. Both POCTs gave a sensitivity of 100% on active syphilis samples with Venereal Disease Research Laboratory (VDRL) titres of greater than 1:4, but their sensitivities decreased for samples with low VDRL titres. Both POCTs gave weakly or very weakly reactive results on 11.3%-25.0% of the treponemal antibody positive samples. This laboratory evaluation has shown promising results for both POCTs to detect infectious syphilis. Further evaluations in the field would be required to confirm this preliminary finding.

Exploring management of antenatally diagnosed fetal syphilis infection.

The incidence of syphilis among Canadian women of childbearing age has risen dramatically in the past decade, with a resurgence of infants born with congenital syphilis. While guidelines exist to guide maternal infection during pregnancy, there is little evidence available to guide management in situations where the developing fetus is found to be severely affected. Our patient presented in the second trimester of her pregnancy as syphilis contact. Positive serologic tests (venereal disease research laboratory titre of 1:64) and a chancre suggested primary infection. Ultrasound demonstrated a fetus at 19+3 weeks gestation with hydrops fetalis and a markedly abnormal brain. Amniocentesis confirmed congenital syphilis infection on polymerase chain reaction testing. After nine days of intravenous penicillin G, the fetal status had worsened, and the family ultimately chose a medical termination of the pregnancy. Evolving ultrasound technology has allowed us to identify severely affected fetuses, who may historically have been delivered stillborn. Following routine syphiliotherapy with benzathine penicillin, these abnormal ultrasound features may take weeks or months to reverse, which poses a challenge in prognostication and counselling. Case reports data suggests intensive treatment with intravenous penicillin may be effective in severe cases where fetal hydrops is present. This case highlights the potential morbidity of fetal syphilis infection and underscores the paucity of current literature. Information sharing will be essential to build a modern knowledge base on treating this ancient disease.

Sexual abuse leading to secondary syphilis in an intellectually disabled person: a case report

<p class="abstract">Syphilis is a sexual transmitted infection (STI) caused by a spirochete, <em>Treponema pallidum</em>. Condylomata lata is a characteristic lesion seen in secondary syphilis. Here we reported a case of 24 year old unmarried male with intellectual disability who presented with condyloma lata over the scrotum, prepuce and perianal region and with moth eaten alopecia over scalp since 1 month. Here the patients mother revealed he had promiscuous relationship with multiple friends, which is a sexual abuse since the patient is intellectually disabled. Clinically diagnosed as secondary syphilis. Venereal disease research laboratory (VDRL) test titre was reactive at 1:32 and <em>Treponema pallidum </em>hemagglutination test (TPHA) was positive. Biopsy was also done, which confirmed diagnosis. Single dose of injection benzathine penicillin G, 2.4 million units was administered intramuscularly. Patient did not develop a Jarisch-herxheimer reaction. On follow up his lesions healed and VDRL titres also came down and non-reactive at 3 months. Here in this case sexual abuse lead to secondary syphilis since patient was intellectually disabled so he couldn’t address his complaints clearly. Hence counselling was done to the patient and family members by dermatologist and psychiatrist.</p><p class="abstract"> </p>

Secondary Syphilis During Pregnancy: The Importance of Screening and Clinical Management

Background: Syphilis is one of the most serious sexually transmitted diseases worldwide, and has tremendous consequences for the mother and her developing fetus if left untreated. The burden of morbidity and mortality due to congenital syphilis is high. Purpose: Screening and prompt to know the importance of treatment of syphilis during pregnancy. Case: A 32-year-old multigravida in 5 months of pregnancy presented with multiple raised lesions over her labia. It was accompanied by fluor and smelly fishy odor. There was no history of genital ulcers in either spouse and no history of sexual promiscuity. History of antenatal care in public health showed non-reactive status of HIV, syphilis and hepatitis B. Clinical examination revealed multiple flat, moist warts over her labia mayora and minora, and multiple roseola syphilitica on the plantar pedis sinistra. Darkfield microscopic examination presence spirochete, venereal disease research laboratory (VDRL) titer was 1:16 and T. pallidum particle agglutination assay (TPHA) titer was 1:2560. Obstetric ultrasonography examination was suggestive no mayor congenital abnormalities. Both of serology VDRL and TPHA were non-reactive in her husband. Significant of lesion improvement and decrease a fourfold titer serologic in VDRL (1:4) and TPHA (1:320) as follow-up 3 months after being treated with single intra-muscular injections of benzathine penicillin 2.4 million units. Discussion: Coordinated prenatal care and treatment are vital. It’s implemented before the fourth month of pregnancy to reduce vertical transmission and all associated side effects of congenital syphilis. Penicillin is highly efficacious in maternal syphilis and prevention of congenital syphilis. Conclusion: Universal screening and adequate pregnancy care must be a priority.

Duration of anti-treponemal immunoglobulin M seroreversion after successful syphilis treatment in HIV-positive and -negative patients.

Treponemal immunoglobulin M (IgM) antibody detection is currently among serologic tests used for syphilis diagnosis. However, the exact role of these antibodies is unclear. In this retrospective study of 326 (198 HIV positive and 128 negative) patients with early syphilis and positive IgM serology, data were analysed to investigate the time of IgM seroreversion after treatment and correlation with covariate factors. Median time of IgM seroreversion in the study population was 9 months (range 3-84, interquartile range 5-12). No statistically significant difference was observed between HIV-positive and -negative patients. At 12 months, 80.1% of the patients had a negative IgM test. At 6 months, 100% of HIV-positive patients had a fourfold decrease or greater in Venereal Disease Research Laboratory titres, but only 35.4% had a negative treponemal IgM. Secondary and early latent stage patients had a slower seroreversion of IgM (Hazard Ratio (HR) = 0.73, p = 0.064 and HR = 0.60, p = 0.023, respectively) than those with primary syphilis. A very strong association was observed of time to seroreversion of treponemal IgM with baseline VDRL titre (p < 0.001). Treponemal IgM antibody detection often cannot distinguish between active and successfully treated syphilis. Treponemal IgM may only be useful in the cases recommended in the guidelines, and in cases of untreated syphilis, it could support but not confirm the diagnosis.

Prevalence of syphilis and associated factors in the adult population treated at healthcare facilities in Vitória (ES), Brazil

Introduction: There are few population-sampling studies on the prevalence of syphilis in Brazil. Objectives: We aim to determine the seroprevalence of syphilis and identify factors associated with the infection in adult patients observed at six regional healthcare facilities in Vitória city, state of Espírito Santo, Brazil. Methods: A cross-sectional study was conducted between September 2010 and December 2011. For individuals included in the study, a Venereal Disease Research Laboratory (VDRL) test and two treponemal tests (immunochromatographic and IgG ELISA assays) were performed. Demographic data, history of sexually transmitted infections, and behavioral data were collected. Results: Of the 1,502 subjects included in the study, 47% were men and 53% were women. The mean age was 41.63±14.57 years. The prevalence of syphilis was (0.9%; 95%CI 0.4–1.3) when a diagnosis of syphilis was considered with VDRL titers equal to or greater than 1:8. However, the prevalence was higher (2.8%) when a positive VDRL test, regardless of the titer, was considered. A multivariate analysis showed a significant association between syphilis and homosexual or bisexual behavior [OR=6.80; 95%CI 1.00–46.20], prior history of sexually transmitted infection [OR=16.30; 95%CI 3.61–73.41], the presence of a tattoo [OR=6.21; 95%CI 1.49–25.84], and cocaine use [OR=6.80; 95%CI 1.15–40.30]. The prevalence of positive treponemal test was 10.4%. Conclusion: The seroprevalence of active syphilis in this population was similar to that observed in other populational studies in Brazil. The high prevalence of positive treponemal tests may be due to the positive serological memory of a cured infection, but the results may also be due to cases of early or late syphilis that were not detected by the VDRL test.

Lues Maligna in an Immune-Reconstituted Patient with Retroviral Infection: A Case Report

Lues Maligna in an Immune-Reconstituted Patient with Retroviral Infection: A Case Report

Increased CCL24 and CXCL7 levels in the cerebrospinal fluid of patients with neurosyphilis.

BackgroundMonocytes are recruited into the cerebrospinal fluid (CSF) of patients with neurosyphilis, suggesting abnormal chemokine expression. We aimed to investigate the aberrant expression of chemokines in the CSF of these patients.MethodsCSF and serum samples were collected from patients with neurosyphilis between July 2017 and June 2019 in the Dermatology Department, Second Affiliated Hospital of Zhejiang University. Differences in the expression of 38 chemokines between patients with and without neurosyphilis were detected using RayBio® Human Chemokine Antibody Array C1. CCL24 and CXCL7 levels in the patients’ CSF and serum were further measured using RayBio® CCL24 and CXCL7 ELISA kits.ResultsNinety‐three CSF and serum samples of patients with syphilis were collected. Antibody array analysis showed that the CSF levels of CCL24 (P = .0185), CXCL7 (P < .0001), CXCL13 (P < .0001), CXCL10 (P < .0001), and CXCL8 (P < .0001) were significantly higher in patients with than without neurosyphilis. ELISA confirmed significantly higher CCL24 and CXCL7 levels in the CSF of patients with than without neurosyphilis (CCL24: 6.082 ± 1.137 pg/mL vs 1.773 ± 0.4565 pg/mL, P = .0037; CXCL7: 664.3 ± 73.19 pg/mL vs 431.1 ± 90.54 pg/mL, P = .0118). Increased CCL24 and CXCL7 expression was seen throughout all neurosyphilis stages, had moderate diagnostic efficiency for neurosyphilis, and correlated poorly with CSF cell count and Venereal Disease Research Laboratory titer. CSF CCL24 levels also correlated poorly with CSF protein concentration.ConclusionAbnormally high CSF chemokines levels may play a role in the pathogenesis of neurosyphilis.

Congenital Syphilis in Honiara, Solomon Islands.

Congenital syphilis remains a significant cause of newborn mortality and long-term neurodevelopmental problems in some low- and middle-income countries. This study was done in Honiara, Solomon Islands to determine the incidence of babies born to mothers with a positive venereal disease research laboratory (VDRL) test and a positive Treponema pallidum haemagglutination assay (TPHA); to determine the VDRL status of newborns and features of congenital syphilis; and to estimate the proportion of stillbirths associated with syphilis. All neonates born to VDRL-positive mothers, including stillbirths were included between April and July 2019. Neonates were examined, investigated and treated. Among 1534 consecutive births, 1469 were live births and 65 (4.2%) were stillbirths. One hundred and forty-three neonates were born to VDRL-positive mothers: 130 (90.1%) were live infants and 13 (8.9%) stillbirths. Of the 130 VDRL-exposed live-born infants, 72 (55%) had reactive VDRL and a positive TPHA and 7 (9.7%) had clinical signs of congenital syphilis. Five of the infants with clinical signs of syphilis infection had a 4-fold higher VDRL titre than their mother. Four infants of VDRL-positive mothers died during admission, all of whom had clinical signs of syphilis. Ninety percent of affected infants were born to mothers who were not treated or only partially treated during pregnancy. In this study, 1:210 live-born babies had clinical and serological evidence of congenital syphilis, and evidence of Treponema infection was found disproportionately in stillbirths. In a setting where Treponema infections are common, an empirical approach to prevention may be needed.

ORAL SYPHILIS: A CASE SERIES WITH ORAL INVOLVEMENT OF A REEMERGING DISEASE

The current literature reported an increase in cases of syphilis in different regions of Latin America. The aim of this study is to present a series of 19 cases from the Oral Medicine Department, Dentistry College, National University of Cordoba in Argentina with secondary syphilis diagnosed by oral lesions and serologic antibody studies from 2010 to 2018. A wide range of variable clinical presentations and Venereal Disease Research Laboratory (VDRL) titers were recorded in order to establish an association between antibody tests and clinical progression of oral lesions. A high increase of the disease diagnosed at our institution in the last decade was also reported worldwide. This phenomenon suggests the reemergence of a sexually transmitted infection that was believed to have been controlled. Oral syphilis mimics many other diseases becoming a diagnostic challenge for the clinician. Early diagnosis of the disease could avoid the spread of the infection.

Leucoderma syphiliticum in a pregnant woman

A 32-year-old woman at 31 weeks’ gestation with a history of premature rupture of membranes presented with asymptomatic hypopigmented macules on her upper back and neck region of 2 months’...

Factors associated with unfavorable outcomes caused by Syphilis infection in pregnancy

Abstract Objective: to analyze factors associated with unfavorable outcomes caused by syphilis infection in pregnancy. Methods: descriptive study carried out from May to August 2014, in public maternity hospitals. A questionnaire was administered to all women with a reactive Venereal Disease Research Laboratory (VDRL) test result and the data were supplemented with information from medical records and prenatal files. The bivariate analysis was performed using Pearson's chi-square or Fisher's exact test. For the multivariate analysis, was used through the logistic regression model. Results: a total of 137 puerperal women participated in the study, of which 14.3% had an unfavorable outcome, namely: stillbirth (2.9%), preterm birth (8.8%) and low birth weight (2.9%). In the multivariate analysis the odds ratio for the prevalence of an unfavorable outcome was three-fold higher in women who did not undergo a second VDRL test (OR=3,54; IC95% 1,04-15,33) and two-fold higher in women with a VDRL titer &gt;1:8 (OR=2,15; IC95% 1,11-11,2). Conclusions: The unfavorable outcomes occurred in women who did not undergo the second VDRL test and those whose VDRL titer was &gt;1:8 performed in the maternity hospital.

Congenital syphilis: a revision of the cases over the last 18 years in a referral hospital in Lisbon

Introduction: Congenital syphilis is a preventable disease and its persistence reflects a failure in prenatal care delivery systems. Objectives: To identify demographic maternal characteristics, risk factors and clinical features of congenital syphilis. The secondary outcome was to describe the symptomatic cases of congenital syphilis. Methods: Retrospective study of all the children born, between 1997-2015, to syphilis seropositive women. We collected data regarding sociodemographic characteristics, maternal VDRL (Venereal Disease Research Laboratory) titers, co-infections and treatment during pregnancy, clinical features, treatment and follow-up. Results: From a total of 80,639 newborns, 310 mothers and 225 babies had positive VDRL titers. The prevalence risk for congenital syphilis was 0.27%, higher between 2003-2008. Observed maternal characteristics were: 3.9% young mothers (< 20 y), 45.2% African origin, 12.5% basic educational levels, 14.5% unemployed, 6.5% co-infected with human immunodeficiency virus (HIV), 4.7% drug abuse. Prenatal care coverage was provided in 82.9% of the mothers, with only 52.9% adequately treated. Maternal syphilis was classified in: 21.6% early, 21.6% late, 56.8% undetermined. The newborns were classified in: 13.2% highly probable, 41.6% possible and 45.2% less likely. There were four cases of symptomatic congenital syphilis, 3 of them with neurosyphilis. 96% were treated with penicillin. 165/310 (53%) had an adequate follow-up, and the mean age for a negative VDRL titer was at 5.6 months of age. Conclusions: The high percentage of women inadequately treated alerts to the importance of improving prenatal care. Neurosyphilis is a rare and severe presentation of congenital syphilis; screening is essential to avoid late cases or sequels.

The ghost of the great imitator: prognostic factors for poor outcome in syphilitic uveitis

BackgroundSyphilitic uveitis is reemerging globally, may lead to any type of intraocular inflammation, and is potentially sight-threatening. We aim to characterize clinical features and prognostic factors in patients with syphilitic posterior uveitis.MethodsRetrospective chart review at two tertiary university-based referral centers in Brazil. Clinical data, laboratory results, and treatment outcomes were analyzed. Statistical analysis was performed using Fisher’s exact test for categorical variables and Mann-Whitney U test for continuous variables.ResultsForty-four patients (81 eyes) were consecutively diagnosed with syphilitic posterior uveitis between March 2011 and April 2013.Thirty-one were male (70.5%) and the mean age was 43.8 years (range 15–81). HIV confection was disclosed in 12 patients (29.3%). The most prevalent finding was vitritis (85.2%), followed by retinal involvement (76.4%) and optic disc abnormalities (63.5%). After treatment, mean visual acuity improved from 1.2 (20/320) to 0.6 (20/80; median 20/30), but 19 eyes (23.5%) persisted with ≤ 1.0 (20/200). Factors associated with final visual acuity ≤ 1.0 despite therapy were prior use of systemic corticosteroids (p = 0.001), higher Venereal Disease Research Laboratory titers (p = 0.004), longer duration of symptoms (p = 0.024), and worse initial VA (p < 0.001).ConclusionsSyphilitic uveitis is reemerging. Delayed diagnosis and inadvertent use of systemic corticosteroids are potentially modifiable prognostic factors to be considered for possibly improving outcomes.