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Ocular syphilis (OS), a manifestation of neurosyphilis, typically presents as uveitis (often with vision loss) early in infection. Recent years have seen increased incidence of this once-rare condition.
Four cases of OS were reported by public health authorities in King County, Washington, between December 1, 2014, and January 30, 2015. All four cases involved men who have sex with men (MSM), two of whom were sex partners; three of the four were HIV-infected (median CD4 count, 111 cells/mm3; median viral load, 34,740 copies/mL). Syphilis was diagnosed by rapid plasma reagin testing. One patient was thought to have late disease, whereas the others were in early stages. All were treated with penicillin. Despite initial improvement, one patient…