(1).jpg)
OKULAR SIFILIS YANG DISERTAI HERPES ZOSTER OFTALMIKUS : LAPORAN KASUS
Abstract
Sifilis dapat menyerang seluruh bagian mata, menjadikannya “great masquerade” dan harus dipertimbangkan pada pasien dengan gangguan sistem imun. Anamnesis, pemeriksaan fisik, pemeriksaan oftalmologi, dan pemeriksaan serologis dapat membedakan sifilis okular dari etiologi lain. Tujuan dari laporan kasus ini adalah untuk melaporkan diagnosis dan penatalaksanaan sifilis mata yang disertai dengan Herpes Zoster Ophthalmic. Pada laporan kasus ini, seorang pasien laki-laki berusia 27 tahun mengeluh erupsi vesikel yang disertai nyeri pada dahi dan kelopak mata kiri sejak dua hari yang lalu, serta pandangan kabur pada kedua mata sejak tujuh bulan yang lalu. Pemeriksaan fisik didapatkan ruam makulopapular pada kedua telapak tangan. Ditemukan sel vitreus dan kabut serta diskus optik bilateral yang kabur. Hasil laboratorium menunjukkan reaktivitas pada VDRL/RPR dan TPHA. Pasien didiagnosis menderita Uveitis Intermediate karena Sifilis, Herpes Zoster Ophthalmic Sinistra, dan Optik Neuritis Atipikal Bilateral. Pasien diberikan Benzatin Penisilin intramuskular, Valasiklovir oral, kortikosteroid sistemik, steroid topikal, dan dirujuk ke dokter spesialis kulit dan kelamin. Herpes Zoster Ophthalmic pada usia muda dapat menjadi tanda kondisi immunocompromised. Anamnesis, pemeriksaan fisik, dan pemeriksaan laboratorium penting dalam menentukan penyebab uveitis. Pasien dengan Okular sifilis akan mendapat manfaat dari terapi antibiotik dini. Kesalahan diagnosis akan menyebabkan kerusakan yang lebih berat dan mempengaruhi tajam penglihatan.
Keywords
Full Text:
PDFReferences
Agarwal, M., Ranjan, R., Paul, L., & Sharma, D. (2018). Syphilitic uveitis misdiagnosed as viral retinitis—a misleading history. Journal of Ophthalmic Inflammation and Infection, 8(1), 4–9. https://doi.org/10.1186/s12348-018-0164-5
Apinyawasisuk, S., Poonyathalang, A., Preechawat, P., & Vanikieti, K. (2016). Syphilitic Optic Neuropathy: Re-emerging Cases over a 2-Year Period. Neuro-Ophthalmology, 40(2), 69–73. https://doi.org/10.3109/01658107.2015.1134586
Brown, D. (2016). The Relationship Between Herpes Zoster, Syphilis and Chickenpox. JAMA, 316(23), 2555. https://doi.org/10.1001/jama.2015.17114
González, M. M., Solano, M. M., Porco, T. C., Oldenburg, C. E., Acharya, N. R., Lin, S. C., & Chan, M. F. (2018). Epidemiology of uveitis in a US population-based study. Journal of Ophthalmic Inflammation and Infection, 8(1), 4–11. https://doi.org/10.1186/s12348-018-0148-5
Gupta, D. M. (2017). Ocular Changes in Sexually Transmitted Diseases: Review of literature. Journal of Medical Science And Clinical Research, 05(03), 18896–18904. https://doi.org/10.18535/jmscr/v5i3.97
Gupta, N., Sachdev, R., Sinha, R., Titiyal, J., & Tandon, R. (2011). Herpes zoster ophthalmicus: Disease spectrum in young adults. Middle East African Journal of Ophthalmology, 18(2), 178–182. https://doi.org/10.4103/0974-9233.80710
Hah, Y. Y., Yap, S. C., HO, S. U. L., TEOH, S., & Agrawal, R. V. (2016). A comparison of ocular syphilis phenotypes between HIV-Infected and non-HIV adult patients. Investigative Ophthalmology & Visual Science, 57(12), 3288.
Hardy, W. D., & Medicine, A. A. of H. (2019). Fundamentals of HIV Medicine 2019. Oxford University Press, Incorporated. https://books.google.co.id/books?id=CNqUDwAAQBAJ
Jones, N. P. (2015). The Manchester Uveitis Clinic: The first 3000 patients--epidemiology and casemix. Ocular Immunology and Inflammation, 23(2), 118–126. https://doi.org/10.3109/09273948.2013.855799
Kobayashi, T., Katsumura, C., Shoda, H., Takai, N., Takeda, S., Okamoto, T., Maruyama, K., Tada, R., Tajiri, K., Kida, T., & Ikeda, T. (2017). A Case of Syphilitic Uveitis in Which Vitreous Surgery Was Useful for the Diagnosis and Treatment. 8686, 55–60. https://doi.org/10.1159/000455910
Motlagh, M. N., & Javid, C. G. (2019). Case Report Presentation of Ocular Syphilis in a HIV-Positive Patient with False-Negative Serologic Screening. Case Reports in Infectious Diseases, 2019(Cmv).
Neri, P., & Pichi, F. (2022). Acute syphilitic posterior placoid chorioretinitis: when the great mimicker cannot pretend any more; new insight of an old acquaintance. Journal of Ophthalmic Inflammation and Infection, 12(1). https://doi.org/10.1186/s12348-022-00286-2
Rishi, E., Govindarajan, M. V, Biswas, J., Agarwal, M., Sudharshan, S., & Rishi, P. (2016). Photo Essay Syphilitic uveitis as the presenting feature of HIV. 149–151. https://doi.org/10.4103/0301-4738.179714
Sahin, O., & Ziaei, A. (2015). Clinical and laboratory characteristics of ocular syphilis, co-infection, and therapy response. Clinical Ophthalmology, 10, 13. https://doi.org/10.2147/OPTH.S94376
Sen, N., Albini, T. A., Burkholder, B. M., Dahr, S. S., Dodds, E. M., & Leveque, T. K. (2019). Infectious Uveitis: Bacterial Causes. In American Academy of Ophthalmology. Basic Clinical Science Course 9: Uveitis and Ocular Inflammation (pp. 219–227). American Academy of Ophthalmology.
Sitompul, R. (2016). Diagnosis dan Penatalaksanaan Uveitis dalam Upaya Mencegah Kebutaan. EJournal Kedokteran Indonesia, 4(1). https://doi.org/10.23886/ejki.4.5913.60-70
Trevelyan, G., Kumar, K., Russell, G. K., & Wickremasinghe, M. (2019). Secondary syphilis presenting with acute unilateral vision loss and a widespread maculopapular rash. 1–4. https://doi.org/10.1136/bcr-2019-230341
Tucker, J. D., Li, J. Z., Robbins, G. K., Davis, B. T., Lobo, A., Kunkel, J., Papaliodis, G. N., Durand, M. L., Felsenstein, D., & Franklin, C. B. (2014). Ocular syphilis among HIV-infected patients : a systematic analysis of the literature. BMJ Journal, 87(1), 4–9. https://doi.org/10.1136/sti.2010.043042
Wasserheit, J., Schünemann, H., & Garcia, P. (2016). WHO Guidelines for the Treatment of Treponema pallidum (Syphilis). World Health Organization, 60.
Weisenthal, R. W., Daly, M. K., Freitas, D., Feder, R. S., Orlin, S. E., Tu, E. Y., Meter, W. S. Van, & Verdier, D. D. (2019). Infectious Diseases of the External Eye: Basic Concepts. In External Disease and Cornea (pp. 266–230). American Academy of Ophthalmology.
Wetarini, K., Made, N., & Mahayani, W. (2020). Diagnosis dan Tatalaksana Uveitis Posterior. 47(8), 673–675.
Whiting, C., Schwartzman, G., & Khachemoune, A. (2023). Syphilis in Dermatology: Recognition and Management. American Journal of Clinical Dermatology, 24(2), 287–297. https://doi.org/10.1007/s40257-022-00755-3
Zhang, T., Zhu, Y., & Xu, G. (2017). Clinical Features and Treatments of Syphilitic Uveitis: A Systematic Review and Meta-Analysis. Journal of Ophthalmology, 2017, 15. https://doi.org/10.1155/2017/6594849
DOI: https://doi.org/10.33024/jmm.v8i2.14302
Refbacks
- There are currently no refbacks.
Copyright (c) 2024 Jurnal Medika Malahayati
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
