The Mydriatic Red Eye as the Initial Presentation of Syphilis

Carlthan J.M. Ling; Kevin Y. Zhang; Kenneth J Taubenslag; Nicole Alexander; Kathryn Champ; Neeraja Murali

doi:10.1016/j.jemermed.2022.05.019

Clinical Communications: Adult| Volume 63, ISSUE 2, P296-299, August 2022

The Mydriatic Red Eye as the Initial Presentation of Syphilis

Carlthan J.M. Ling
Carlthan J.M. Ling
Affiliations
Department of Ophthalmology and Visual Sciences, University of Maryland Medical Center, Baltimore, Maryland
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Kevin Y. Zhang, MD
Kevin Y. Zhang
Affiliations
Creighton University Medical School, Omaha, Nebraska
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Kenneth J Taubenslag
Kenneth J Taubenslag
Affiliations
Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, Maryland
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Nicole Alexander
Nicole Alexander
Affiliations
Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland
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Kathryn Champ
Kathryn Champ
Affiliations
Department of Internal Medicine, University of Maryland Medical Center, Midtown Campus, Baltimore, Maryland
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Neeraja Murali
Neeraja Murali
Correspondence
Corresponding Author. Neeraja Murali, Department of Emergency Medicine, University of Maryland School of Medicine, 110 South Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201
Contact
Affiliations
Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland
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Published:May 17, 2022DOI:https://doi.org/10.1016/j.jemermed.2022.05.019

Abstract

Background

Syphilis is a sexually transmitted infection that has been increasing in prevalence since the early 2000s. Ocular involvement occurs in a minority of patients and must be in the differential diagnosis for patients who present with red eye and uveitis.

Case Report

A 29-year-old woman presented to the emergency department with a painful, mydriatic red eye. Review of systems revealed a rash as well as a recent genital lesion and, on further questioning, she admitted to a history of intravenous drug use and high-risk sexual activity. Ophthalmology was consulted and the patient was diagnosed with bilateral uveitis. Serologic testing was positive for syphilis, and she was admitted and treated with intravenous penicillin, with resolution of her uveitis.

Why Should an Emergency Physician Be Aware of This?

Red eye is a common ocular symptom in patients presenting to the emergency department. The differential diagnosis of the red eye is broad and can range from benign etiologies, such as conjunctivitis, to life- and sight-threatening conditions, such as endogenous endophthalmitis. Systemic diseases such as syphilis may present with primarily ocular symptoms, and ocular syphilis must be identified and managed appropriately to prevent devastating sequelae.

Keywords

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Article info

Publication history

Published online: May 17, 2022

Accepted: May 9, 2022

Received: April 11, 2022

Footnotes

Written consent was obtained from the patient. A copy of the consent is available upon request.

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DOI: https://doi.org/10.1016/j.jemermed.2022.05.019

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The Mydriatic Red Eye as the Initial Presentation of Syphilis

Abstract

Background

Case Report

Why Should an Emergency Physician Be Aware of This?

Keywords

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References

Article info

Publication history

Footnotes

Identification

Copyright

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