How is ophthalmic syphilis in HIV infection treated?

Updated: Jul 21, 2021
  • Author: Luca Rosignoli, MD; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Answer

Answer

All HIV-positive patients with syphilitic eye findings are considered to have neurosyphilis and are treated accordingly. Treatment of syphilis is with intravenous penicillin G (24 million U/day for 7-10 days). Relapse may occur despite adequate treatment. For penicillin-allergic patients, alternatives include tetracycline 500 mg 4 times per day or doxycycline 200 mg twice a day by mouth for 30 days or a third-generation cephalosporin (eg, ceftriaxone), although penicillin desensitization should be considered.

Cycloplegia and topical steroid therapy is recommended if anterior segment inflammation is present.


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