Neurosyphilis

Power point of case of a 66 year old male with acute vision loss OD to no light perception. Underwent extensive work-up for cardiovascular and neurologic etiologies, all negative. Subsequent serologic work-up was positive for syphilis and the diagnosis of neurosyphilis was confirmed by lumbar puncture. Patient was treated with IV penicillin and remained stable. Discussion of syphilis diagnosis, prognosis and treatment. Imaging: Number of Figures and legend for each: 6 Slide 4: Figure 1: Table showing examination findings of case Slide 5: Figure 2: Fundus photograph OD centered on optic disc showing mild temporal pallor with C/D 0.5 without edema or peripapillary hemorrhage; arterioles attenuated, no cherry red spot or thromboembolus/plaque Slide 6: Figure 3: Fundus photograph OS showing normal disc with C/D 0.4; mild arteriolar attenuation, no cherry red spot or thromboembolus/plaque Slide 7: Figure 4: Fluorescein angiography OD showing delayed choroidal and retinal arterial filling Slide 8: Figure 5: OCT RNFL showing thinning superiorly and inferiorly OD Slide 15: Figure 6: Flow chart showing routes of infection in syphilis and disease course (Adapted from: JAMA. 2003;290:1510-1514)