A Rare Case of Rash, Blurry Vision, and Papilledema Caused by Isolated Ocular Syphilis
Bibliographic record
Abstract
Papilledema is a high-risk cause of vision changes in the Emergency Department (ED) and a critical physical examination finding because of its close association with etiologies that may progress to vision loss or death. Syphilis is a rare infectious cause of papilledema, with scarce case reports published showing its ability to develop such sequela. We present a case of a 35-year-old male with a past medical history of newly diagnosed HIV who originally presented to the ED with a rash and rapidly worsening visional changes. While in the ED, the patient developed a brief syncopal episode and acute vision loss, after which concern for increased intracranial pressure and possible opportunistic infection guided the clinicians to perform a bedside point of care ultrasound (POCUS) that confirmed bilateral papilledema. The patient ultimately had an expedited work-up that rendered a diagnosis of syphilitic papillitis and uveitis without associated neurosyphilis. With the growing incidence of syphilis in the US, we aim to shed light on the rare diagnosis of isolated ocular syphilis in hopes of increasing awareness of this potentially vision-threatening pathology. This case also serves as an important reminder of the utility of POCUS in working up undifferentiated visual complaints and concerns of papilledema.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".