Author's Name: Cemile Handan Misirli, Tamer Bayram, Nese Erdogan, Sevda Gökçeer and Duygu Özkan
Subject Area: Health Science
Subject Other
Section Research Paper




Introduction: Neurosyphilis is still an important medical problem in developing countries and syphilitic ocular manifestations are often not diagnosed easily. We present a case with neurosyphilis with clinical findings and investigation. Case report: We describe the case of a 43-year- old taxi driver man with a 6 month history of decreased visual acuity and color perception in both eyes, but mainly in his right eye. The patient also had vertiginous complaint and nystagmus with toward every ways of eye movements for 3 months. Fundus examinations revealed pale optic disc with blurred margin in both eyes. There were multiple hyperintense lesions and minimal atrophy at cranial MRI. Blood analysis showed positive VDRL and TPHA titer of >1/40.960. Cerebrospinal fluid evaluation for syphilis showed lymphocytic pleocytosis and increased protein content and VDRL titer of 1/16 and RPR (+). The patient was diagnosed with neurosyphilis and received ceftriacsone 1gr flacon 1x2 iv/day for 14 days. He felt himself better after treatment and vertigo disappeared but his optic atrophy continued. Conclusions: Neurosyphilis should be thought and investigated in the differential diagnosis of optic atrophy.

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