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Di Landro A. 1, Fontana P. 2, Barcella A. 1, D’Anna G. 1, Foiadelli L. 1, Imberti G. 1, Marchesi G. 1
1 USC Dermatologia, Ospedali Riuniti di Bergamo, Università degli Studi di Milano, Milano, Italia
2 USC Oculistica Ospedali Riuniti di Bergamo, Bergamo, Italia
The incidence of syphilis has been rising internationally over the last decade because of the increasing rate of high-risk sexual behavior. Also ocular syphilis, very rare after the introduction of penicillin therapy, is increasing and it seems to be a sign of the coinfection with the HIV. Ocular manifestations of the disease are heterogeneous and difficult to diagnosis solely by clinical presentation; they can involve any structure of the eye from the eyelids to optic nerve. Iridocyclitis is the most common manifestation, but due to the variety of ocular signs that mimic other diseases, ocular syphilis is known as “the great impersonator”. A case of a 24-year-old boy with only anterior uveitis as clinical sign of the infection is described. He resulted coinfected by HIV. Although he was treated with intravenous penicillin-G, 24 million units per day, for at least 12 days, he had a very important visual loss. His young girlfriend resulted positive to syphilitic infection, but fortunately not to HIV. The article presents and discusses this unusual presentation of syphilis infection.