This abstract is assigned to sessions
| Presentation preference | Poster and Rapid fire |
| Title | Acute Syphilitic Posterior Placoid Chorioretinitis treated by Doxycycline and Benzathine Penicillin |
| Accept poster if oral is not possible ? | Yes |
| Purpose | To report a case of syphilitic uveitis with acute syphilitic posterior placoid chorioretinitis(ASPPC) successfully treated with combination doxycycline and benzathine penicillin G(BPG) when refusal of intravenous(IV) treatment. |
| Methods | A retrospective case report. |
| Results | A 31 y/o man with a history of human immunodeficiency virus infection came for bilateral acute visual loss since 1 week ago. At presentation, the best corrected visual acuity(BCVA) was counting finger OD and 0.3 OS. Fundal examination was invisible OD and revealed a whitish placoid macular lesion OS. Left macular OCT showed loss of ellipsoid zone with many subretinal infiltrates. Systemic workup reported strong positive syphilis results. Early-phase fluorescein angiography showed a placoid hyperfluorescent staining macular lesion with blocked fluoresence in ICG angiography, which was well-demarcated in late-phase image, compatible with diagnosis of ASPPC. For refusal of IV treatment, he started with oral doxycycline 200mg/BID for 4 weeks. However, we found abnormal liver enzyme and persistent ocular inflammation, so he received a subsequent intramuscular BPG 2.4MU weekly for 3 weeks. After completing treatment, ocular inflammation was subsided and BCVA improved to 20/20 OU. 6 months after completing treatment, we found an 8-fold decrease of serum nontreponemal test , proving a lab evidence of treatment response. No recurrence was noted during 1-year follow-up period. |
| Conclusion | ASPPC is an uncommon but clinically distinct presentation of syphilitic uveitis. Our case report showed excellent treatment outcome of combination doxycycline and BPG when refusal of IV treatment. |
| Conflict of interest | No |
Author 1
| Last name | CHEN |
| Initials of first name(s) | HF |
| Department | Mackay Memorial Hospital |
| City | Hsinchu |
| Country | Taiwan |
