Dr. ASHOK KUMAR

Dr.Poninder Kumar Dogra, Dr.Sanjay Kumar Mishra, Dr. Sumit Goyal

Abstract

Purpose

To report rare presentation of great imitator; hypopyon associated acute syphilitic posterior placoid chorioretinitis ; subsequently diagnosed to be HIV positive.

Methods

A young male presented with diminution of vision in right eye and anterior chamber showing hypopyon. Fundus exam showed placoid lesion involving post pole ,vitreous cells and no evidence of retinal vasculitis. Investigations revealed positive serology for syphilis; subsequent ELISA and western blot for HIV also positive.

Results:-Patient managed with antiretroviral therapy and injectable penicillin with resolution of inflammation as well as placoid chrioretinitis with improvement in vision.

Conclusion:- The syphilis; a great imitator can have varied ocular presentations especially in underlying immune-compromised state which poses a diagnostic challenge. A clinical presentation based evaluation can help in diagnosis of concurrent infections when syphilis is re-emerging as global public health problem.