Unraveling an Enigmatic Triad: A Case Report of Concurrent Neurosyphilis, Ocular Syphilis, and Otosyphilis in a Patient with HIV
Introduction: Patients with HIV disease, regardless of the phase of infection, can present with overlapping stages and less distinct signs of syphilis, complicating diagnosis and treatment. Treponema pallidum, the bacterium responsible for syphilis, can lead to neurosyphilis, ocular syphilis, and ot...
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| Format: | Article |
| Language: | English |
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eScholarship Publishing, University of California
2025-02-01
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| Series: | Clinical Practice and Cases in Emergency Medicine |
| Online Access: | https://escholarship.org/uc/item/4v30g38h |
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| author | Peter Njouda Shitebongnju Alexander A. Bobrov |
| author_facet | Peter Njouda Shitebongnju Alexander A. Bobrov |
| author_sort | Peter Njouda Shitebongnju |
| collection | DOAJ |
| description | Introduction: Patients with HIV disease, regardless of the phase of infection, can present with overlapping stages and less distinct signs of syphilis, complicating diagnosis and treatment. Treponema pallidum, the bacterium responsible for syphilis, can lead to neurosyphilis, ocular syphilis, and otosyphilis when left untreated. Therefore, early detection of syphilis coinfection in HIV patients and timely treatment have demonstrated prompt improvement of symptoms, mitigating the risk of serious complications. Case Report: We report the case of a 39-year-old previously incarcerated male with a significant history of HIV on antiretroviral therapy and previous methamphetamine abuse referred to the emergency department from an ophthalmologist with a diagnosis of anterior uveitis and papilledema. The patient reported experiencing blurry vision, tinnitus, and memory difficulties. A thorough history and physical examination, along with diagnostic procedures, including lumbar puncture and cerebrospinal fluid analysis, corroborated the diagnosis of neurosyphilis with otic and ocular involvement. The patient underwent a 14-day course of intravenous aqueous crystalline penicillin G, resulting in symptom improvement. Conclusion: Given the prevalence of syphilis and its diverse manifestations, clinicians must maintain a high index of suspicion in patients who engage in high-risk behaviors to facilitate early diagnosis and treatment, which are crucial for optimal outcomes and enhanced prognosis. |
| format | Article |
| id | doaj-art-ff574041c2de4977ba460d0708b4deab |
| institution | Kabale University |
| issn | 2474-252X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Clinical Practice and Cases in Emergency Medicine |
| spelling | doaj-art-ff574041c2de4977ba460d0708b4deab2025-08-20T03:47:32ZengeScholarship Publishing, University of CaliforniaClinical Practice and Cases in Emergency Medicine2474-252X2025-02-019217317710.5811/cpcem.21309cpcem-9-173Unraveling an Enigmatic Triad: A Case Report of Concurrent Neurosyphilis, Ocular Syphilis, and Otosyphilis in a Patient with HIVPeter Njouda Shitebongnju0Alexander A. Bobrov1St. Rita’s Medical Center, Division of Emergency Medicine, Lima, OhioSt. Rita’s Medical Center, Division of Emergency Medicine, Lima, OhioIntroduction: Patients with HIV disease, regardless of the phase of infection, can present with overlapping stages and less distinct signs of syphilis, complicating diagnosis and treatment. Treponema pallidum, the bacterium responsible for syphilis, can lead to neurosyphilis, ocular syphilis, and otosyphilis when left untreated. Therefore, early detection of syphilis coinfection in HIV patients and timely treatment have demonstrated prompt improvement of symptoms, mitigating the risk of serious complications. Case Report: We report the case of a 39-year-old previously incarcerated male with a significant history of HIV on antiretroviral therapy and previous methamphetamine abuse referred to the emergency department from an ophthalmologist with a diagnosis of anterior uveitis and papilledema. The patient reported experiencing blurry vision, tinnitus, and memory difficulties. A thorough history and physical examination, along with diagnostic procedures, including lumbar puncture and cerebrospinal fluid analysis, corroborated the diagnosis of neurosyphilis with otic and ocular involvement. The patient underwent a 14-day course of intravenous aqueous crystalline penicillin G, resulting in symptom improvement. Conclusion: Given the prevalence of syphilis and its diverse manifestations, clinicians must maintain a high index of suspicion in patients who engage in high-risk behaviors to facilitate early diagnosis and treatment, which are crucial for optimal outcomes and enhanced prognosis.https://escholarship.org/uc/item/4v30g38h |
| spellingShingle | Peter Njouda Shitebongnju Alexander A. Bobrov Unraveling an Enigmatic Triad: A Case Report of Concurrent Neurosyphilis, Ocular Syphilis, and Otosyphilis in a Patient with HIV Clinical Practice and Cases in Emergency Medicine |
| title | Unraveling an Enigmatic Triad: A Case Report of Concurrent Neurosyphilis, Ocular Syphilis, and Otosyphilis in a Patient with HIV |
| title_full | Unraveling an Enigmatic Triad: A Case Report of Concurrent Neurosyphilis, Ocular Syphilis, and Otosyphilis in a Patient with HIV |
| title_fullStr | Unraveling an Enigmatic Triad: A Case Report of Concurrent Neurosyphilis, Ocular Syphilis, and Otosyphilis in a Patient with HIV |
| title_full_unstemmed | Unraveling an Enigmatic Triad: A Case Report of Concurrent Neurosyphilis, Ocular Syphilis, and Otosyphilis in a Patient with HIV |
| title_short | Unraveling an Enigmatic Triad: A Case Report of Concurrent Neurosyphilis, Ocular Syphilis, and Otosyphilis in a Patient with HIV |
| title_sort | unraveling an enigmatic triad a case report of concurrent neurosyphilis ocular syphilis and otosyphilis in a patient with hiv |
| url | https://escholarship.org/uc/item/4v30g38h |
| work_keys_str_mv | AT peternjoudashitebongnju unravelinganenigmatictriadacasereportofconcurrentneurosyphilisocularsyphilisandotosyphilisinapatientwithhiv AT alexanderabobrov unravelinganenigmatictriadacasereportofconcurrentneurosyphilisocularsyphilisandotosyphilisinapatientwithhiv |