9 June 2023

Clinical Alert regarding syphilis - from British Association for Sexual Health and HIV (BASHH)

If you see a patient with unknown cause of a red eye condition or visual disturbance you should have a low threshold for suspecting syphilis.

The rates of syphilis are increasing in the UK. Specialist sexual health clinics (GUM services) are seeing increasing presentations of both asymptomatic syphilis and, complex secondary and neurosyphilis. 

This means people are going undiagnosed and often now left with long term complications of syphilis infection.

If you see a patient with unknown cause of a red eye condition or visual disturbance you should have a low threshold for suspecting syphilis and consider whether you should advise them to have a blood test for syphilis, particularly if they consider themselves in an at-risk group for the disease. Mild conjunctivitis is common in secondary syphilis. Episcleritis, scleritis, keratitis and uveitis in later stages of disease.

If you have concerns about a patient, ask them to speak to their local GUM service provider or GP who will be happy to help.

Related further reading

This study reports on an audit carried out in the emergency eye care (EEC) service at the University Hospitals of Leicester NHS Trust.

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