Syphilis Uveitis: A Case of Occam's Razor, Hickam's Dictum, and Crabtree's Bludgeon
Recommended Citation
Sethi D, Mohiddin O, Kelleher C, Kasetty VM, Kumar N, Desai UR, and Hamad A. Syphilis Uveitis: A Case of Occam's Razor, Hickam's Dictum, and Crabtree's Bludgeon. Cureus 2025;17(8):e89329.
Document Type
Article
Publication Date
8-1-2025
Publication Title
Cureus
Keywords
maculopapular rash, neurosyphilis, syphilis uveitis, tb – tuberculosis, uveitis
Abstract
This report discusses a case of diagnosing neurosyphilis in a non-classical presentation with confounding test results needing a deliberate and multidisciplinary diagnostic approach. A 38-year-old immunocompetent male presented with uveitis and a skin rash. Although serology was positive for syphilis (rapid plasma reagin 1:128), it was also positive for tuberculosis, and a dermatology consult identified the rash as psoriasis, creating a complex diagnostic picture. Based on a high suspicion of ocular syphilis, the patient received intravenous penicillin, which led to the complete resolution of his ocular symptoms and a serologically confirmed cure. This case of an ophthalmic masquerading disease was complicated by misleading clinical signs and a coexisting positive serology, serving as a reminder to maintain a broad differential diagnosis and be systematic in workup and management in order to optimize clinical outcomes.
PubMed ID
40918778
Volume
17
Issue
8
First Page
89329
Last Page
89329
