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Chancre of the eyelid as manifestation of primary syphilis, and precocious chorioretinitis and uveitis in an HIV-infected patient: a case report

Salvatore Cillino1*, Francesco Di Pace1, Marcello Trizzino2, Valentina Li Vecchi3 and Paola Di Carlo2

Author Affiliations

1 Department of Experimental Biomedicine and Clinical Neuroscience, Ophthalmology Section, University of Palermo, Via Liborio Giuffrè 13, 90127, Palermo, Italy

2 Department of Sciences for Health Promotion “G. D’Alessandro”, Infectious Diseases Section, University of Palermo, Palermo, Italy

3 Department of Internal Medicine and Specialties, University of Palermo, Palermo, Italy

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BMC Infectious Diseases 2012, 12:226  doi:10.1186/1471-2334-12-226

Published: 25 September 2012



Ocular syphilis is often difficult to diagnose because of the wide variation in clinical features.

HIV co-infection may further complicate the picture.

Case presentation

Herein the authors report an unusual primary syphilitic ocular lesion in a 45-year-old Italian HIV-infected bisexual man who presented with a unilateral eyelid lesion. Associated precocious signs and symptoms in the posterior segment of both eyes, bilateral chorioretinitis and uveitis, are described. Intravenous penicillin and steroid treatment produced a rapid improvement in clinical status and complete resolution.


Careful questioning about sexual behavior is crucial for unmasking unusual features of ocular syphilis in HIV-infected subjects.

Ocular syphilis; HIV-infected; Chancre of the eyelid; Bilateral chorioretinitis; Uveitis