Does a low serofast RPR titer (such as 1:1 or 1:2) in the setting of a remote history of appropriately treated latent syphilis in a patient with now uveitis of yet unknown etiology referred from ophthalmology for possible ocular syphilis make a diagnosis of ocular syphilis less likely?
What is your approach to guiding ophthalmologists regarding our clinical suspicion for ocular syphilis and does the quantification of the titer help in this situation, or do you always err on the side of offering empiric treatment for ocular syphilis with IV penicillin course?
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Would you treat for ocular syphilis in a patient referred by ophthalmology with an RPR titer of 1:1 or 1:2 and a remote history of appropriately treated latent syphilis, who now presents with uveitis of unknown etiology?
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1 Answer
Mednet MemberInvited Expert
Infectious Disease · Yale School of Medicine
Answered on
I err on the side of offering empiric treatment. As syphilis rates have risen over the past 20 years, so has the incidence of syphilitic uveitis (Mir et al., PMID 37991790), and the question posed, therefore, represents a not uncommonly encountered conundrum for infectious disease consultants. Syphi...
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