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Erschienen in: Der Ophthalmologe 4/2017

14.03.2017 | HIV | CME

Lues – Okuläre Syphilis

verfasst von: PD Dr. T. Neß

Erschienen in: Die Ophthalmologie | Ausgabe 4/2017

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Zusammenfassung

Die okuläre Syphilis ist kein neues, aber durch ansteigende Infektionszahlen wieder ein aktuelles Thema. Das klinische Erscheinungsbild ist bunt und kann alle Formen einer entzündlichen Augenbeteiligung annehmen. Besonders häufig findet sich eine unspezifische anteriore Uveitis. Typische Krankheitsbilder sind aber oberflächliche weiße präretinale Präzipitate im Rahmen einer Panuveitis und die akute syphilitische posteriore plakoide Chorioretinitis. Die Sicherung der Diagnose erfolgt durch serologische Verfahren. Zur Therapie wird die parenterale Gabe von Penicillin eingesetzt.
Literatur
1.
2.
Zurück zum Zitat Marra CM, Maxwell CL, Smith SL, Lukehart SA, Rompalo AM, Eaton M et al (2004) Cerebrospinal fluid abnormalities in patients with syphilis: association with clinical and laboratory features. J Infect Dis 189:369–376CrossRefPubMed Marra CM, Maxwell CL, Smith SL, Lukehart SA, Rompalo AM, Eaton M et al (2004) Cerebrospinal fluid abnormalities in patients with syphilis: association with clinical and laboratory features. J Infect Dis 189:369–376CrossRefPubMed
5.
Zurück zum Zitat Butler NJ, Thorne JE (2012) Current status of HIV infection and ocular disease. Curr Opin Ophthalmol 23:517–522CrossRefPubMed Butler NJ, Thorne JE (2012) Current status of HIV infection and ocular disease. Curr Opin Ophthalmol 23:517–522CrossRefPubMed
6.
Zurück zum Zitat Jones NP (2015) The Manchester Uveitis Clinic: the first 3000 patients – epidemiology and casemix. Ocul Immunol Inflamm 23:118–126CrossRefPubMed Jones NP (2015) The Manchester Uveitis Clinic: the first 3000 patients – epidemiology and casemix. Ocul Immunol Inflamm 23:118–126CrossRefPubMed
7.
Zurück zum Zitat Patton ME, Su JR, Nelson R, Weinstock H, Centers for Disease Control and Prevention (CDC) (2014) Primary and secondary syphilis – United States, 2005–2013. MMWR Morb Mortal Wkly Rep 63:402–406PubMed Patton ME, Su JR, Nelson R, Weinstock H, Centers for Disease Control and Prevention (CDC) (2014) Primary and secondary syphilis – United States, 2005–2013. MMWR Morb Mortal Wkly Rep 63:402–406PubMed
9.
Zurück zum Zitat Doris JP, Saha K, Jones NP, Sukthankar A (2006) Ocular syphilis: the new epidemic. Eye Lond Engl 20:703–705 Doris JP, Saha K, Jones NP, Sukthankar A (2006) Ocular syphilis: the new epidemic. Eye Lond Engl 20:703–705
10.
Zurück zum Zitat Fonollosa A, Giralt J, Pelegrín L, Sánchez-Dalmau B, Segura A, García-Arumí J et al (2009) Ocular syphilis – back again: understanding recent increases in the incidence of ocular syphilitic disease. Ocul Immunol Inflamm 17:207–212CrossRefPubMed Fonollosa A, Giralt J, Pelegrín L, Sánchez-Dalmau B, Segura A, García-Arumí J et al (2009) Ocular syphilis – back again: understanding recent increases in the incidence of ocular syphilitic disease. Ocul Immunol Inflamm 17:207–212CrossRefPubMed
11.
Zurück zum Zitat Mathew RG, Goh BT, Westcott MC (2014) British Ocular Syphilis Study (BOSS): 2‑year national surveillance study of intraocular inflammation secondary to ocular syphilis. Invest Ophthalmol Vis Sci 55:5394–5400CrossRefPubMed Mathew RG, Goh BT, Westcott MC (2014) British Ocular Syphilis Study (BOSS): 2‑year national surveillance study of intraocular inflammation secondary to ocular syphilis. Invest Ophthalmol Vis Sci 55:5394–5400CrossRefPubMed
12.
Zurück zum Zitat Lefebvre M, Biron C, Guillouzouic A, Juvin ME, Masseau A, Néel A et al (2013) Syphilis in Nantes tertiary care hospital between 2000 and 2010: a case series of 36 hospitalized patients. Rev Med Interne 34:522–527CrossRefPubMed Lefebvre M, Biron C, Guillouzouic A, Juvin ME, Masseau A, Néel A et al (2013) Syphilis in Nantes tertiary care hospital between 2000 and 2010: a case series of 36 hospitalized patients. Rev Med Interne 34:522–527CrossRefPubMed
13.
Zurück zum Zitat Khairallah M, Yahia SB, Ladjimi A, Messaoud R, Zaouali S, Attia S et al (2007) Pattern of uveitis in a referral centre in Tunisia, North Africa. Eye 21:33–39CrossRefPubMed Khairallah M, Yahia SB, Ladjimi A, Messaoud R, Zaouali S, Attia S et al (2007) Pattern of uveitis in a referral centre in Tunisia, North Africa. Eye 21:33–39CrossRefPubMed
14.
Zurück zum Zitat Yang P, Zhang Z, Zhou H, Li B, Huang X, Gao Y et al (2005) Clinical patterns and characteristics of uveitis in a tertiary center for uveitis in China. Curr Eye Res 30:943–948CrossRefPubMed Yang P, Zhang Z, Zhou H, Li B, Huang X, Gao Y et al (2005) Clinical patterns and characteristics of uveitis in a tertiary center for uveitis in China. Curr Eye Res 30:943–948CrossRefPubMed
15.
Zurück zum Zitat Karaconji T, Maconochie Z, McCluskey P (2013) Acute anterior uveitis in Sydney. Ocul Immunol Inflamm 21:108–114CrossRefPubMed Karaconji T, Maconochie Z, McCluskey P (2013) Acute anterior uveitis in Sydney. Ocul Immunol Inflamm 21:108–114CrossRefPubMed
16.
Zurück zum Zitat Ness T, Pleyer U, Neudorf U, Frosch M (2007) Infectious uveitis in infancy: Borreliosis, Tuberculosis, Lues. Klin Monatsbl Augenheilkd 224(6):488–493CrossRefPubMed Ness T, Pleyer U, Neudorf U, Frosch M (2007) Infectious uveitis in infancy: Borreliosis, Tuberculosis, Lues. Klin Monatsbl Augenheilkd 224(6):488–493CrossRefPubMed
18.
Zurück zum Zitat Woolston SL, Dhanireddy S, Marrazzo J (2016) Ocular syphilis: a clinical review. Curr Infect Dis Rep 18:36CrossRefPubMed Woolston SL, Dhanireddy S, Marrazzo J (2016) Ocular syphilis: a clinical review. Curr Infect Dis Rep 18:36CrossRefPubMed
19.
Zurück zum Zitat Amaratunge BC, Camuglia JE, Hall AJ (2010) Syphilitic uveitis: a review of clinical manifestations and treatment outcomes of syphilitic uveitis in human immunodeficiency virus-positive and negative patients. Clin Experiment Ophthalmol 38:68–74CrossRefPubMed Amaratunge BC, Camuglia JE, Hall AJ (2010) Syphilitic uveitis: a review of clinical manifestations and treatment outcomes of syphilitic uveitis in human immunodeficiency virus-positive and negative patients. Clin Experiment Ophthalmol 38:68–74CrossRefPubMed
20.
Zurück zum Zitat Kiss S, Damico FM, Young LH (2005) Ocular manifestations and treatment of syphilis. Semin Ophthalmol 20:161–167CrossRefPubMed Kiss S, Damico FM, Young LH (2005) Ocular manifestations and treatment of syphilis. Semin Ophthalmol 20:161–167CrossRefPubMed
21.
22.
Zurück zum Zitat Browning DJ (2000) Posterior segment manifestations of active ocular syphilis, their response to a neurosyphilis regimen of penicillin therapy, and the influence of human immunodeficiency virus status on response. Ophthalmology 107:2015–2023CrossRefPubMed Browning DJ (2000) Posterior segment manifestations of active ocular syphilis, their response to a neurosyphilis regimen of penicillin therapy, and the influence of human immunodeficiency virus status on response. Ophthalmology 107:2015–2023CrossRefPubMed
23.
Zurück zum Zitat Kuo IC, Kapusta MA, Rao NA (1998) Vitritis as the primary manifestation of ocular syphilis in patients with HIV infection. Am J Ophthalmol 125:306–311CrossRefPubMed Kuo IC, Kapusta MA, Rao NA (1998) Vitritis as the primary manifestation of ocular syphilis in patients with HIV infection. Am J Ophthalmol 125:306–311CrossRefPubMed
24.
Zurück zum Zitat Moradi A, Salek S, Daniel E, Gangaputra S, Ostheimer TA, Burkholder BM et al (2015) Clinical features and incidence rates of ocular complications in patients with ocular syphilis. Am J Ophthalmol 159:334–343.e1CrossRefPubMed Moradi A, Salek S, Daniel E, Gangaputra S, Ostheimer TA, Burkholder BM et al (2015) Clinical features and incidence rates of ocular complications in patients with ocular syphilis. Am J Ophthalmol 159:334–343.e1CrossRefPubMed
25.
Zurück zum Zitat Ormerod LD, Puklin JE, Sobel JD (2001) Syphilitic posterior uveitis: correlative findings and significance. Clin Infect Dis 32:1661–1673CrossRefPubMed Ormerod LD, Puklin JE, Sobel JD (2001) Syphilitic posterior uveitis: correlative findings and significance. Clin Infect Dis 32:1661–1673CrossRefPubMed
26.
Zurück zum Zitat Lobes LA, Folk JC (1981) Syphilitic phlebitis simulating branch vein occlusion. Ann Ophthalmol 13:825–827PubMed Lobes LA, Folk JC (1981) Syphilitic phlebitis simulating branch vein occlusion. Ann Ophthalmol 13:825–827PubMed
28.
Zurück zum Zitat Fu EX, Geraets RL, Dodds EM, Echandi LV, Colombero D, McDonald HR et al (2010) Superficial retinal precipitates in patients with syphilitic retinitis. Retina 30:1135–1143CrossRefPubMed Fu EX, Geraets RL, Dodds EM, Echandi LV, Colombero D, McDonald HR et al (2010) Superficial retinal precipitates in patients with syphilitic retinitis. Retina 30:1135–1143CrossRefPubMed
29.
Zurück zum Zitat Wickremasinghe S, Ling C, Stawell R, Yeoh J, Hall A, Zamir E (2009) Syphilitic punctate inner retinitis in immunocompetent gay men. Ophthalmology 116:1195–1200CrossRefPubMed Wickremasinghe S, Ling C, Stawell R, Yeoh J, Hall A, Zamir E (2009) Syphilitic punctate inner retinitis in immunocompetent gay men. Ophthalmology 116:1195–1200CrossRefPubMed
30.
Zurück zum Zitat Reddy S, Cunningham ET, Spaide RF (2006) Syphilitic retinitis with focal inflammatory accumulations. Ophthalmic Surg Lasers Imaging 37:429–431PubMed Reddy S, Cunningham ET, Spaide RF (2006) Syphilitic retinitis with focal inflammatory accumulations. Ophthalmic Surg Lasers Imaging 37:429–431PubMed
31.
Zurück zum Zitat Eandi CM, Neri P, Adelman RA, Yannuzzi LA, Cunningham ET, International Syphilis Study Group (2012) Acute syphilitic posterior placoid chorioretinitis: report of a case series and comprehensive review of the literature. Retina 32:1915–1941CrossRefPubMed Eandi CM, Neri P, Adelman RA, Yannuzzi LA, Cunningham ET, International Syphilis Study Group (2012) Acute syphilitic posterior placoid chorioretinitis: report of a case series and comprehensive review of the literature. Retina 32:1915–1941CrossRefPubMed
32.
Zurück zum Zitat Gass JD, Braunstein RA, Chenoweth RG (1990) Acute syphilitic posterior placoid chorioretinitis. Ophthalmology 97:1288–1297CrossRefPubMed Gass JD, Braunstein RA, Chenoweth RG (1990) Acute syphilitic posterior placoid chorioretinitis. Ophthalmology 97:1288–1297CrossRefPubMed
33.
Zurück zum Zitat Pichi F, Ciardella AP, Cunningham ET, Morara M, Veronese C, Jumper JM et al (2014) Spectral domain optical coherence tomography findings in patients with acute syphilitic posterior placoid chorioretinopathy. Retina 34:373–384CrossRefPubMed Pichi F, Ciardella AP, Cunningham ET, Morara M, Veronese C, Jumper JM et al (2014) Spectral domain optical coherence tomography findings in patients with acute syphilitic posterior placoid chorioretinopathy. Retina 34:373–384CrossRefPubMed
34.
Zurück zum Zitat Schwartz GS, Harrison AR, Holland EJ (1998) Etiology of immune stromal (interstitial) keratitis. Cornea 17:278–281CrossRefPubMed Schwartz GS, Harrison AR, Holland EJ (1998) Etiology of immune stromal (interstitial) keratitis. Cornea 17:278–281CrossRefPubMed
35.
Zurück zum Zitat Cantor AG, Pappas M, Daeges M, Nelson HD (2016) Screening for syphilis: updated evidence report and systematic review for the US preventive services task force. JAMA 315:2328–2337CrossRefPubMed Cantor AG, Pappas M, Daeges M, Nelson HD (2016) Screening for syphilis: updated evidence report and systematic review for the US preventive services task force. JAMA 315:2328–2337CrossRefPubMed
36.
Zurück zum Zitat Cornut P‑L, Sobas CR, Perard L, De Bats F, Salord H, Manificat HJ et al (2011) Detection of Treponema pallidum in aqueous humor by real-time polymerase chain reaction. Ocul Immunol Inflamm 19:127–128CrossRefPubMed Cornut P‑L, Sobas CR, Perard L, De Bats F, Salord H, Manificat HJ et al (2011) Detection of Treponema pallidum in aqueous humor by real-time polymerase chain reaction. Ocul Immunol Inflamm 19:127–128CrossRefPubMed
38.
39.
Zurück zum Zitat Restivo L, Abbouda A, Nardella C, Bruscolini A, Pirraglia MP, Pivetti Pezzi P (2013) Uveitis heralding previously unknown luetic and HIV infection. Syphilitic uveitis in an Italian referral center. Ann Ist Super Sanita 49:133–137PubMed Restivo L, Abbouda A, Nardella C, Bruscolini A, Pirraglia MP, Pivetti Pezzi P (2013) Uveitis heralding previously unknown luetic and HIV infection. Syphilitic uveitis in an Italian referral center. Ann Ist Super Sanita 49:133–137PubMed
40.
Zurück zum Zitat Workowski KA, Bolan GA, Centers for Disease Control and Prevention (2015) Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep 64:1–137CrossRefPubMed Workowski KA, Bolan GA, Centers for Disease Control and Prevention (2015) Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep 64:1–137CrossRefPubMed
41.
Zurück zum Zitat Chao JR, Khurana RN, Fawzi AA, Reddy HS, Rao NA (2006) Syphilis: reemergence of an old adversary. Ophthalmology 113:2074–2079CrossRefPubMed Chao JR, Khurana RN, Fawzi AA, Reddy HS, Rao NA (2006) Syphilis: reemergence of an old adversary. Ophthalmology 113:2074–2079CrossRefPubMed
42.
Zurück zum Zitat Fathilah J, Choo MM (2003) The Jarisch-Herxheimer reaction in ocular syphilis. Med J Malaysia 58:437–439PubMed Fathilah J, Choo MM (2003) The Jarisch-Herxheimer reaction in ocular syphilis. Med J Malaysia 58:437–439PubMed
Metadaten
Titel
Lues – Okuläre Syphilis
verfasst von
PD Dr. T. Neß
Publikationsdatum
14.03.2017
Verlag
Springer Medizin
Erschienen in
Die Ophthalmologie / Ausgabe 4/2017
Print ISSN: 2731-720X
Elektronische ISSN: 2731-7218
DOI
https://doi.org/10.1007/s00347-017-0477-z

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