SYPHILITIC UVEITIS: Diagnosis, Herxheimer Reaction and Results of Various Treatments, Including Penicillin Therapy

SYPHILIS AS ETIOLOGIC AGENT  SYPHILITIC uveitis¹ characteristically occurs in the secondary or late secondary stage of syphilis. When there is clinical evidence of early syphilis, a positive Wassermann reaction and prompt retrogression of the ocular inflammation after antisyphilitic treatment, the diagnosis offers no difficulty.How valid is the diagnosis of syphilitic uveitis based solely on a positive Wassermann reaction? Or how sound is such a diagnosis in the late stage of syphilis or when the duration of the infection is unknown? What are the criteria of efficacy of antisyphilitic treatment to justify the conclusion that uveitis was caused by syphilis ? Antisyphilitic treatment exerts a nonspecific effect on uveitis.Judgment at times is difficult, since local treatment and nonsyphilitic therapy also exert a favorable action on uveitis. The purpose of this paper is to discuss these considerations, as well as the Herxheimer reaction² of the ocular lesion as