Syphilitic Neuroretinitis with Positive Cytomegalovirus Serology in an Immunocompetent Adolescent: A Case Report.

IF 0.6 Q4 OPHTHALMOLOGY

Case Reports in Ophthalmology Pub Date : 2026-07-21 eCollection Date: 2026-01-01 DOI:10.1159/000553652

Sundip Dware Chhetri, Meena Kunwar, Ram Krishna Baral, Alina Karki, Sabina Maharjan, Basanta Kumar Bastola, Mohini Thapa, Bibek Pun, Sudeep Lal Rajbhandari

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引用次数: 0

Abstract

Introduction: Neuroretinitis is an inflammatory optic neuropathy characterized by optic disc edema followed by macular star formation. It is most commonly caused by Bartonella henselae, but other infectious etiologies including syphilis and cytomegalovirus (CMV) should be considered, particularly due to their potential for severe visual morbidity if untreated.

Case presentation: A 17-year-old immunocompetent female presented with unilateral visual blurring and headache. Ophthalmologic examination revealed optic disc edema, macular star exudates, and peripapillary hemorrhages in the right eye. Dermatologic examination revealed features consistent with secondary syphilis, and the diagnosis was further supported by laboratory investigations confirming syphilis. Serologic testing also demonstrated positive CMV IgM and IgG antibodies. HIV testing was negative. The patient was treated with intravenous ceftriaxone and ganciclovir followed by oral valganciclovir. Complete anatomical and functional recovery was achieved with restoration of visual acuity.

Conclusion: This case highlights the importance of comprehensive infectious evaluation in neuroretinitis, even in immunocompetent individuals. Early diagnosis and appropriate targeted antimicrobial therapy are essential to prevent permanent visual loss.

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免疫功能正常青少年巨细胞病毒血清学阳性的梅毒性神经视网膜炎一例报告。

简介：神经视网膜炎是一种以视盘水肿伴黄斑星形形成为特征的炎性视神经病变。它最常由亨selae巴尔通体引起，但也应考虑其他感染性病因，包括梅毒和巨细胞病毒（CMV），特别是由于如果不治疗，它们可能导致严重的视觉疾病。病例介绍：一名17岁的免疫功能正常的女性，表现为单侧视力模糊和头痛。眼科检查发现右眼视盘水肿、黄斑星状渗出及乳头周围出血。皮肤检查显示与继发性梅毒相符的特征，实验室检查证实梅毒进一步支持诊断。血清学检测也显示CMV IgM和IgG抗体阳性。艾滋病毒检测呈阴性。患者静脉注射头孢曲松和更昔洛韦，随后口服缬更昔洛韦。解剖和功能完全恢复，视力恢复。结论：本病例强调了在神经视网膜炎中进行综合感染性评估的重要性，即使在免疫正常的个体中也是如此。早期诊断和适当的靶向抗菌治疗对于预防永久性视力丧失至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Case Reports in Ophthalmology OPHTHALMOLOGY-

CiteScore

0.90

自引率

0.00%

发文量

129

审稿时长

12 weeks

期刊介绍： This peer-reviewed online-only journal publishes original case reports covering the entire spectrum of ophthalmology, including prevention, diagnosis, treatment, toxicities of therapy, supportive care, quality-of-life, and survivorship issues. The submission of negative results is strongly encouraged. The journal will also accept case reports dealing with the use of novel technologies, both in the arena of diagnosis and treatment. Supplementary material is welcomed. The intent of the journal is to provide clinicians and researchers with a tool to disseminate their personal experiences to a wider public as well as to review interesting cases encountered by colleagues all over the world. Universally used terms can be searched across the entire growing collection of case reports, further facilitating the retrieval of specific information. Following the open access principle, the entire contents can be retrieved at no charge, guaranteeing easy access to this valuable source of anecdotal information at all times.