Syphilis presenting as optic neuritis in an immunocompetent patient: Case report

The purpose of this report was to present a case of optic neuropathy as a manifestation of secondary syphilis in an human immunodeficiency virus (HIV)-negative patient. A case of gradual loss of visual acuity in the left eye (LE) in a 53-year-old healthy woman was described. The patient present with visual acuity of 20/20 in the right eye and hand movements in the LE. Fundoscopy revealed swollen optic disc in the LE. Fluorescein angiography showed leakage of dye from the optic disc. Optical coherence tomography (OCT) confirmed the oedema in the left optic disc. Serologic testing was positive for venereal disease research laboratory (VDRL) and fluorescent treponemal antibody absorption (FTA-ABS), and negative for HIV antibodies. Ophthalmologic findings, including disc oedema, may be the presenting features of syphilis, therefore ophthalmologists have the opportunity to play a key role in the diagnosis and management of this disease, important for a good visual outcome. This study reports an infrequent case of unilateral optic neuropathy as presenting symptom of syphilis in an immunocompetent patient.   Key words: Syphilis, optic neuropathy, immunocompetent, penicillin.