Syphilis and the Monk

Alejandra Decanini-Mancera, Simmons Lessell, Michael S. Lee, Prem S. Subramanian

Research output: Contribution to journalArticlepeer-review


Primary orbital aspergillus infection may occur in immunocompetent individuals. It frequently represents a diagnostic challenge for clinicians due to nonspecific clinical presentations and neuroimaging signs. We present a 47-year-old otherwise healthy man with an isolated unilateral optic neuropathy secondary to primary orbital aspergillosis. He had a remote history of tuberculosis and positive syphilis serologies. After he worsened despite intravenous penicillin therapy, a biopsy showed chronic inflammation. Corticosteroids treatment was followed by further deterioration of his clinical condition. Finally, a repeat biopsy revealed the aspergillus infection. Despite antifungal therapy, the outcome was unfavorable. A high index of suspicion should result in aggressive diagnostic testing and prompt institution of antifungal therapy in patients with primary orbital aspergillosis.

Original languageEnglish (US)
Pages (from-to)267-273
Number of pages7
JournalSurvey of ophthalmology
Issue number3
StatePublished - May 2011


  • Antifungal therapy
  • Aspergillus infection
  • Corticosteroids
  • Primary orbital Aspergillosis

ASJC Scopus subject areas

  • Ophthalmology


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