AIDS Complicated by Syphilis Can Mimick Uveitis and Crohn's Disease

Abstract

To the Editor. —The association of ocular inflammation and Crohn's disease is well known.¹ We recently saw a patient with uveitis whose bowel inflammation was mistaken for Crohn's disease. He was eventually shown to have syphilitic uveitis associated with the acquired immunodeficiency syndrome (AIDS). A 42-year-old man was referred to the Emory Eye Clinic, Atlanta, in November 1986 with a history of Crohn's disease and iritis, unresponsive to topical steroid therapy. He stated that seven months previously he had experienced diarrhea and anal pain; sigmoidoscopy and biopsy had led to a diagnosis of Crohn's disease. Examination showed a visual acuity of 20/60 OD and 20/20 OS. Mild anterior chamber and vitreous inflammation were present in both eyes. Both fundi were normal, except for edema of the right optic nerve. Because the ocular inflammation was believed to be quiescent, a decision was made to decrease the topical steroid dosage and