Table 1.
Patient | Age, years |
CD4+ cell count, cells/μL |
HIV RNA copies/ mLa |
Serum RPR level |
CSF VDRL test result |
CSF WBC count, cells/μL |
Ocular examination result | Visual acuity |
Antibiotic regimend | Syphilis recurrence |
|
---|---|---|---|---|---|---|---|---|---|---|---|
Before treatmentb |
After treatmentc |
||||||||||
1 | 31 | 217 | 25,740 | 1:256 | 1:2 | 141 | Panuveitis | 20/800 | 20/63 | Intravenous penicillin for 2 weeks, intramuscular penicillin for 3 weeks | No |
2 | 38 | 532 | <400 | 1:128 | NR | 12 | Anterior uveitis | … | … | Intravenous penicillin for 2 weeks, intramuscular penicillin for 1 week | No |
3 | 54 | 539 | <50 | 1:256 | NR | 2 | Posterior uveitis, optic neuritis | 20/80 | 20/25 | Intravenous penicillin for 2 weeks | No |
4e | 41 | 228 | 188,000 | 1:2048 | 1:2 | 20 | Panuveitis, optic neuritis | 20/400 | 20/20 | Intravenous penicillin for 2 weeks | Yes |
5 | 52 | 237 | 174,000 | 1:128 | NR | 1 | Anterior uveitis, optic neuritis | 20/25 | 20/20 | Intravenous penicillin for 3 weeks | No |
6 | 36 | 745 | 54,500 | 1:1024 | 1:1 | 12 | Panuveitis, optic neuritis | CF | 20/20 | Intravenous penicillin for 2 weeks intramuscular penicillin for 1 week | No |
7 | 36 | 472 | <50 | 1:256 | NR | 4 | Posterior uveitis | 20/320 | 20/25 | Intravenous penicillin for 2 weeks, intramuscular penicillin for 3 weeks | Yes |
8 | 36 | 780 | 3380 | 1:256 | 1:4 | 11 | Posterior uveitis | Intravenous penicillin for 2 weeks, intramuscular penicillin for 3 weeks | No | ||
9f | 26 | 348 | 1850 | 1:128 | … | … | Anterior uveitis | 20/20 | Intramuscular/intravenous penicillin for 10 days | Yes | |
10 | 46 | 599 | <50 | 1:256 | NR | 5 | Anterior uveitis | 20/60 | 20/25 | Intramuscular penicillin for 10 days | No |
11 | 23 | 747 | 240,222 | 1:512 | 1:16 | 187 | Anterior uveitis | CF | 20/40 | Intravenous penicillin for 2 weeks | No |
12 | 45 | 305 | <48 | 1:64 | NR | 3 | Optic neuritis | 20/20 | 16/15 | Intravenous penicillin for 1 week, oral doxycycline for 28 days | No |
13 | 55 | 142 | <48 | 1:128 | NR | 1 | Panuveitis, optic neuritis | 20/200 | 20/32 | Intravenous penicillin for 2 weeks, intramuscular penicillin for 1 week | No |
NOTE. CSF, cerebrospinal fluid; NR, nonreactive; RPR, rapid plasma reagin; WBC, white blood cell.
All 5 patients receiving antiretroviral therapy had viral loads less than the limit of detection.
Visual acuity scores of the more severely affected eye; CF, able to count fingers only from ≤3 feet; original reports detailing visual acuity examination unavailable for 2 patients.
All posttreatment visual acuities tested within 3 months.
Intravenous penicillin dosage was 24 MU daily; intramuscular penicillin, 2.4 MU weekly; oral doxycycline, 200 mg twice daily; patients 9 and 10 were treated with 2.4 MU intramuscular procaine penicillin daily with probenecid 500 mg 4 times per day; patient 9 was switched to intravenous penicillin after the fourth day.
Patient described in the case report.
Declined lumbar puncture.