The epidemiology of syphilis and ocular syphilis in Taiwan.
Purpose
To investigate the epidemiology of syphilis and analyze the characteristics of ocular syphilis and in Taiwan.
Methods
The epidemiology was investigated among the reported syphilis cases to Taiwan Center for Disease Control and Prevention (CDC). The characteristic of ocular syphilis was analyzed in tertiary referral center from 2009-2022 as well.
Results
The incidence of syphilis 40.9 per 100000 population and male-to-female ratio revealed 11:1 in 2022. The reported case numbers with syphilis to Taiwan CDC increased from 4158 at 2001, peak 9835 at 2019, to 9632 cases at 2022. There were 21 cases (29 eyes) were diagnosed as ocular syphilis in tertiary referral centers from 2009 to 2022. Patients were mainly male (18 cases; 85.7%). Median age was 46.1 (19-81) years. The ocular lesions included: panuveitis (19 eyes; 65.5%), posterior uveitis (6 eyes), anterior uveitis (2 eye), uveoscleritis (1 eye), papillitis (1 eyes). Co-infection with human immunodeficiency virus (HIV) was found in 17 patients (80.9%) . All 21 cases were treated with PCN with 85.7% (18/21) serologic cure. Three cases showed poor visual outcome (LP, NLP) in the cases with optic nerve involvement.
Conclusion
Syphilis re-emerged and commonly occurred in man in Taiwan. Ocular syphilis highly correlated with HIV infection and panuveitis is the most common presentation. Ocular syphilis should be treated as neurosyphilis. Ocular syphilis with optic nerve involvement may lead to guard prognosis. Careful diagnosis and prompt treatment are necessary.
Conflict of interest
No
Authors 1
Last name
TSAI
Initials of first name(s)
M.L.
Department
Department of Ophthalmology, Taipei Tzu-Chi Hospital
City
New Taipei
Country
Taiwan
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