Ocular Syphilis as a Cause of Chronic Postoperative Uveitis Followed by a Localized Ocular Jarisch–Herxheimer-like Reaction. (16th March 2023)

• Record Type: Journal Article
• Authors: Forouzan, Parsha; Fell, David; Jones, Freddie R.
• Is Part Of: Ocular immunology and inflammation. Volume 31:Number 3(2023)
• Page Start: 649
• Page End: 652
• Publication Date: 2023-03-16
• Subjects: Ocular syphilis -- neurosyphilis -- latent syphilis -- postoperative uveitis -- Jarisch-Herxheimer reaction; Eye -- Diseases -- Immunological aspects -- Periodicals; Eye -- Inflammation -- Periodicals; 617.7
• DOI: 10.1080/09273948.2022.2042321
• Languages: English
• ISSNs: 0927-3948

Abstract

ABSTRACT: Objective: The case draws attention to syphilis as a cause of chronic postoperative uveitis following cataract surgery and is the first to document transient worsening of ocular inflammation without systemic symptoms after initiation of treatment, suggesting a localized Jarisch–Herxheimer-like reaction. Design: Case report. Results: The average thickness of the retinal nerve fiber layer was used as an objective measure of intraocular inflammation. The patient's nerve edema worsened during a standard neurosyphilis treatment course and returned to normal several weeks after completion of therapy. Conclusion: Syphilis serologic testing should be strongly considered in the work-up for chronic postoperative uveitis. A localized ocular Jarisch–Herxheimer-like reaction may occur and should not detract from completion of neurosyphilis treatment.