A Rare Case of Blindness Caused by Syphilis with Malignant Hypertensive Nephropathy

Intern Med. 2023 Nov 1;62(21):3195-3201. doi: 10.2169/internalmedicine.1436-22. Epub 2023 Mar 22.

Abstract

The number of patients with syphilis has been rapidly increasing. Without treatment, syphilis can damage various organs and become life-threatening. We herein report a 29-year-old woman diagnosed with neurosyphilis, acute hydrocephalus, syphilitic uveitis combined with hypertensive retinopathy, and malignant hypertensive nephropathy. To our knowledge, this is the first report of syphilis complicated with malignant hypertensive nephropathy proven by a renal biopsy. Neurosyphilis was successfully treated with intravenous penicillin G, and severe hypertension subsequently resolved. However, delayed medical examinations and complications of syphilitic uveitis and hypertensive retinopathy resulted in irreversible visual loss. To prevent irreversible organ damage, early treatment is essential.

Keywords: hydrocephalus; hypertensive nephropathy; hypertensive retinopathy; malignant hypertension; neurosyphilis; syphilis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Blindness / complications
  • Female
  • Humans
  • Hypertension, Renal
  • Hypertensive Retinopathy* / complications
  • Kidney Diseases* / complications
  • Nephritis
  • Neurosyphilis* / complications
  • Neurosyphilis* / diagnosis
  • Neurosyphilis* / drug therapy
  • Syphilis* / complications
  • Syphilis* / diagnosis
  • Syphilis* / drug therapy
  • Uveitis* / etiology

Supplementary concepts

  • Hypertensive Nephropathy