A Case of Acute Interstitial Keratitis in a Patient with Acquired Syphilis. |
Tae Jin Kim, Han Gyul Yoon, Jae Woong Koh |
Department of Ophthalmology, Chosun University School of Medicine, Gwangju, Korea. ophkoh@hanmail.net |
후천성매독환자에 발생한 급성 사이질각막염 1예 |
김태진⋅윤한결⋅고재웅 |
조선대학교 의학전문대학원 안과학교실 |
Correspondence:
Jae Woong Koh, Email: ophkoh@hanmail.net |
Received: 13 October 2016 • Revised: 17 November 2016 • Accepted: 17 January 2017 |
Abstract |
PURPOSE To report a case of acute interstitial keratitis as the first clinical sign in a patient with latent syphilis. CASE SUMMARY: A 23-year-old female presented with visual impairment and discomfort in her right eye that developed 3 days earlier. The visual acuity in the right eye was 20/200 and corrected to 20/100, and slit lamp examination showed round sub-epithelial opacification in the central cornea with stromal edema and neovascularization on the cornea of the right eye. Whole body tests including serological tests were performed. Under the suspicion of acute interstitial keratitis, topical antibiotics and steroids were applied 4 times a day initially. Serological tests were reactive for venereal disease research laboratory test (VDRL). Under the suspicion of acute interstitial keratitis due to syphilis, fluorescent treponemal antibody absorption test IgM/IgG (FTA-ABS IgM/IgG) was performed; a positive result for FTA-ABS IgG led to diagnosis of acute interstitial keratitis with latent syphilis. During treatment, systemic doxycycline 200 mg for 4 weeks with topical antibiotics and steroids were administered, the opacity and edema of the cornea regressed after 2 weeks of treatment, and visual acuity in the patient's right eye improved to 20/20. CONCLUSIONS: We report an unusual case of acute interstitial keratitis as the first clinical manifestation of latent syphilis in an immunocompetent patient. |
Key Words:
Acquired syphilis;Interstitial keratitis;Ocular syphilis;Treponema pallidum |