Syphilis: Washington reports 6 ocular syphilis cases in past month, blindness reported in two

Outbreak News Today
Robert Herriman
Original Article:

Since mid-December 2014, the Washington Department of Health has reported six cases of ocular syphilis, or syphilis of the eyes, causing blindness in at least two patients.

This funduscopic image reveals the effects of late neuro-ocular syphilis on the optic disk and retina/CDC
Four of the cases occurred in King County, while the other two are from elsewhere in the state.

All four of the recent King County cases occurred in men, three of whom identified as men who have sex with men (MSM), the group most affected by syphilis in King County. Three of the cases were HIV-infected, though two were not receiving HIV medical care. Two of the cases were sex partners and presumed to be epidemiologically linked, prompting health officials to issue advisories for health care providers and the gay and bisexual men population.

All of the patients presented primarily with visual complaints, a combination of loss of vision, floaters, a blue tinge in vision, flashing lights and blurring of vision.

Ophthalmologic examinations revealed uveitis with variable retinal involvement. Three patients underwent lumbar puncture, all of whom had CSF pleocytosis and two of whom had a positive CSF VDRL. Three of the patients were admitted to a hospital for intravenous penicillin. One patient has so far refused treatment; Public Health and medical providers continue to encourage this man to accept therapy.

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