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April 1967

Spirochetes in the Aqueous Humor in Seronegative Ocular SyphilisPersistence After Penicillin Therapy

Author Affiliations

Miami, Fla
From the Department of Ophthalmology, University of Miami (Fla) School of Medicine.

Arch Ophthalmol. 1967;77(4):474-477. doi:10.1001/archopht.1967.00980020476009

A young woman with a gradual onset of blurred vision was found to have a bitemporal hemianopia. It was possible that these symptoms represented an early optochiasmatic arachnoiditis. Inflammatory eye changes with bilateral neuroretinitis and anterior uveitis were then noted. A protracted course of exacerbations and remissions occurred during a one-year course of systemic steroid therapy. After a reactive fluorescent treponemal antibody absorption test was found, spirochetes were demonstrated in the aqueous humor. The patient was then given more than nine million units of long-acting penicillin. One month later, at a second paracentesis, spirochetes were again found. These organisms were motile on darkfield examination, and stained with fluorescein tagged anti-Treponema pallidum globulin.