Acute Syphilitic Posterior Placoid Chorioretinitis in an Immunocompetent Patient-Case Report

免疫功能正常病患之急性梅毒後極部盾狀脈絡膜視網膜炎－病例報告

李昆憲(Kun-Hsien Li) ； 林純如(Chun-Ju Lin) ； 黃峻峰(Jiunn-Feng Hwang) ； 陳珊霓(San-Ni Chen)

《中華民國眼科醫學會雜誌》 50卷1期 (2011/04) Pp. 152-156

https://doi.org/10.30048/ACTASOS.201104.0022

摘要

目的：報告一例免疫功能正常病患之急性梅毒後極部盾狀脈絡膜視網膜炎。方法：病例報告。結果：一位四十一歲的男性病人表現雙眼漸進視力模糊以及多處盾狀脈絡膜視網膜炎。此盾狀病灶於口服類固醇治療後漸改善，但視力仍持續模糊。血清學報告：rapid plasma regain（RPR）及treponema pallidum particle agglutination均呈陽性，與急性梅毒後極部盾狀脈絡膜視網膜炎之診斷符合。病患對肌肉注射盤尼西林效果反應快且良好。結論：由於眼部梅毒之表現具廣泛之多樣性，且缺乏特定之表徵，故診斷有賴於高度之懷疑。對眼部不明原因發炎之病患，例行施行RPR檢測是洽當的。由於此疾病對治療之反應極佳，及早作出此診斷是重要的。可避免誤用類固醇造成之不良結果。

並列摘要

Purpose: To report a case of acute syphilitic posterior placoid chorioretinitis in an immunocompetent patient. Method: Interventional case report. Results: A 41-year-old male patient presented with progressive blurred vision and multiple placoid patches of chorioretinitis in both eyes. The placoid lesion improved after oral prednisolone treatment, but blurred vision persisted. Serum test showed a positive rapid plasmin reagin and treponema pallidum particle agglutination test, compatible with acute syphilitic placoid posterior chorioretinitis. The patient responded quickly and well to an intramuscular benzathine penicillin injection. Conclusion: Owing to a wide variety of presentations and a lack of pathognomonic features, the diagnosis of ocular syphilis requires a high index of suspicion. Routine survey of rapid plasma reagin is feasible for patients presenting with ocular inflammation of an unknown origin. It is important to establish an early diagnosis because such patients respond well to appropriate treatment. Thus, unfavorable results caused by unnecessary steroid use can be avoided.

並列關鍵字

ocular syphilis ； acute syphilitic posterior placoid chorioretinitis ； uveitis