Optic Disc Edema and Osteolytic Skull Lesions in a Patient With Syphilitic Intermediate Uveitis

Ocular syphilis is a 'great mimicker' of eye diseases due to its highly variable presentation. Optic disc involvement in ocular syphilis includes neuroretinitis, perineuritis, optic neuritis, and inflammatory disc edema. There are few reports of syphilitic osteomyelitis as a manifestation of early syphilis in the literature with an incidence of 0.15% described in a large case series of 10,000 patients by Reynolds and Wasserman in 1942. Huang et al. described unusual lytic lesions on MRI and CT in a patient with syphilitic osteomyelitis of the skull.