Sestre Milosrdnice University hospital and Institute of Clinical Medical Research
Abstract
Syphilis, a disease which used to be terminal up to the 1950s, has become curable with the discovery of penicillin. In the last few years, an increase in its incidence has been recorded in the world as well as in Croatia, primarily with the human immunodeficiency virus (HIV) co-infection. We present a 40-year-old male patient who complained of a sudden decrease of visual acuity on both eyes, accompanied by dizziness. Clinical examination revealed low visual acuity and blurred edges of the optical nerve head without prominence. Pulse corticosteroid therapy failed to produce any recovery of visual acuity. Additional tests were done including Treponema pallidum hemagglutination assay (TPHA), which confirmed the infection with Treponema pallidum. The patient was administered Extencillin therapy. As a reaction to therapy administered, the patient.s visual acuity gradually fully recovered. In the medical literature available, there is no report of optical neuritis as the first and only manifestation of HIV and syphilis co-infection.Sifilis, bolest koja je do pedesetih godina prošloga stoljeća bila smrtonosna, otkrićem penicilina postala je izlječivom. U posljednjih nekoliko godina bilježi se porast incidencije kako u svijetu tako i kod nas, osobito uz suinfekciju virusom humane imunodeficijencije (HIV). Prikazujemo slučaj 40-godišnjeg muškarca koji se javio zbog naglog pada vidne oštrine na oba oka praćenog vrtoglavicom. Pri kliničkom pregledu utvrđena je niska vidna oštrina te glava vidnog živca nejasnih brisanih granica bez prominencije. Propisana pulsna kortikosteroidna terapija nije dovela do očekivanog oporavka vidne oštrine, pa su učinjene dodatne pretrage, među kojima i test hemaglutinacijske reaktivnosti Treponema pallidum (TPHA), kojim se dokazala infekcija bakterijom Treponema pallidum. Bolesniku je propisana terapija Extencillinom. Ova terapija je dovela do potpunog oporavka vidne oštrine. U dostupnoj medicinskoj literaturi, prema našim saznanjima, dosad nije opisan slučaj optičkog neuritisa kao prve i jedine manifestacije suinfekcije HIV i sifilisa
