Clinical and laboratory characteristics of ocular syphilis and neurosyphilis among individuals with and without HIV infection

dc.contributor.advisorSmit, Derricken_ZA
dc.contributor.authorMathew, Dony Korahen_ZA
dc.contributor.otherStellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Ophthalmology.en_ZA
dc.date.accessioned2023-01-26T06:39:46Zen_ZA
dc.date.available2023-01-26T06:39:46Zen_ZA
dc.date.issued2022en_ZA
dc.descriptionThesis (MMed)--Stellenbosch University, 2022.en_ZA
dc.description.abstractENGLISH ABSTRACT: BACKGROUND/AIMS: In the era of increasing incidence of syphilis globally, ocular syphilis is re-emerging as an important cause of uveitis. The aim of this study was to determine the clinical and laboratory characteristics of ocular- and neurosyphilis among individuals with and without HIV infection. METHODS: Retrospective analysis of patients diagnosed with ocular syphilis presenting to Tygerberg Hospital, South Africa, over a 5-year period ending December 2018. RESULTS: Two-hundred-and-fifteen eyes of 146 patients were included. HIV co-infection was present in 52.1% of the patients, with 23.7% of these patients being newly diagnosed on presentation. The median age was 36.5 + 9.8 years. Bilateral involvement occurred in 47.3%; with 68.1% of these patients being HIV positive. The most frequent form of intraocular inflammation was posterior uveitis (40.9%), followed by panuveitis (38.1%); both of which were more predominant in HIV-positive eyes. Seventy-four percent of all eyes had a visual acuity < 20/50 and 40% < 20/200 at presentation. A lumbar puncture was performed in 113 patients (77.4%). Sixteen patients had confirmed neurosyphilis and 27 probable neurosyphilis according to the UpToDate algorithms. CONCLUSION: This study included the largest number of ocular syphilis cases with the largest proportion of HIV infection to date. Forty-three of 146 patients (29.5%) had neurosyphilis. HIV status must be determined in all patients with ocular syphilis since almost ¼ of patients were newly diagnosed with HIV infection by doing so.en_ZA
dc.description.abstractAFRIKAANSE OPSOMMING: DOELWIT: In die tydperk van verhoogde insidensie van sifilis wêreldwyd, verskyn okulêre sifilis ook as ‘n belangrike oorsaak van uveitis. Die doel van hierdie studie is om die kliniese en laboratorium eienskappe van okulêre- en neurosifilis in pasiënte met en sonder MIV infeksie te bepaal. METODES: ‘n Retrospektiewe analise van pasiënte gediagnoseer met okulêre sifilis by Tygerberg Hospitaal, Suid Afrika, in die 5 jaar periode tot en met Desember 2018. RESULTATE: Twee honderd en vyftien oë van 146 pasiënte is ingesluit. MIV infeksie was teenwoordig in 52.1% van die pasiënte, met 23.7% van hierdie pasiënte wat nuut gediagnoseer was met MIV. Die mediaan ouderdom was 36.5 + 9.8 jaar. Bilaterale aantasting was teenwoordig in 47.3%; met 68.1% van hierdie pasiënte wat MIV positief was. Die mees algemene vorm van uveitis was posterior uveitis (40.9%), gevolg deur panuveitis (38.1%); waarvan beide meer algemeen was in MIV positiewe pasiënte.Vier en sewentig persent van pasiënte het gesigskerpte van < 20/50 en 40% het < 20/200 gehad met diagnose. ‘n Lumbale punksie is gedoen in 113 pasiënte (77.4%). Sestien pasiënte het bevestigde neurosifilis en 27 moontlike neurosifilis gehad volgens die UpToDate algoritmes. SLOTSOM: Hierdie studie het die grootste getal pasiënte tot dusver met okulêre sifilis en die grootste persentasie wat met MIV besmet is ondersoek. Drie en veertig van die 146 pasiënte (29.5%) het ook neurosifilis gehad. MIV status moet in elke pasiënt met okulêre sifilis bepaal word aangesien byna ¼ van hierdie pasiënte nuut gediagnoseer was met MIV infeksie.af_ZA
dc.description.versionMastersen_ZA
dc.format.extent11 pages : illustrationsen_ZA
dc.identifier.urihttp://hdl.handle.net/10019.1/126388
dc.language.isoen_ZAen_ZA
dc.publisherStellenbosch : Stellenbosch University
dc.rights.holderStellenbosch Universityen_ZA
dc.subject.lcshNeurosyphilisen_ZA
dc.subject.lcshUveitisen_ZA
dc.subject.lcshHIV infectionen_ZA
dc.titleClinical and laboratory characteristics of ocular syphilis and neurosyphilis among individuals with and without HIV infectionen_ZA
dc.typeThesisen_ZA
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