DR. ANKITA SINGH

DR.DR. ASHOK KUMAR, DR.(MAJ) SHANKAR SANDEEP

Abstract

We describe a rare case of a HIV patient who presented with unique evolution of bilateral syphilitic neuroretinitis with outer retinal necrosis involving posterior pole like retinitis. . Laboratory workup revealed low CD4 count of 30/µL, with a high HIV viral load, positive VDRL serology, positive IgG antibodies forcytomegalovirus (CMV).The retinitis in both eyes responded well to intravenous Acyclovir therapy followed by oral Acyclovir as maintanence therapy. Independent from one another, both progressive outer retinal necrosis (PORN) and syphilitic neuroretinitis are rare ocular infections that can present in immunocompromised patients. Timely recognition and prompt treatment of PORN is crucial as visual acuity deteriorates rapidly and it could be the first manifestation of AIDS. Unless there is a concerted effort to curb the transmission of syphilis; it will continue to lead to substantial morbidity and further fuel the HIV pandemic.