DR.SAI BHAKTI MISHRA

DR. PADMAMALINI MAHENDRA DAS, DR. ANKUSH KAWALI, DR.SANJAY SRINIVASAN

Abstract

Purpose: We are reporting the clinical characteristics of paradoxical worsening of ocular inflammation in 3 patients with syphilis while on treatment with anti-syphilitic treatment.

Cases: A 35-year-old female presented with right eye post-operative hypopyon uveitis with syphilis. A 40-year-old middle aged male presented with syphilitic bilateral panuveitis with characteristic posterior hyaloid precipitates. A 56-year-old female presented with syphilitic placoid retinochoroiditis in the right eye. All three patients showed initial improvement with anti-syphilitic treatment but later developed paradoxical worsening and were treated with additional topical and oral corticosteroids and showed good response to treatment.

Conclusion: Paradoxical worsening in ocular inflammation with syphilis has been rarely reported in literature. After ruling out alternative diagnosis, poor compliance and drug resistance, these patients can be effectively treated with additional corticosteroids.