“Ocular syphilis with reactive arthritis mimicking rheumatoid arthritis” – A diagnostic dilemma, case report, and review of literature

Syphilis is a great mimicker of diseases and has a broad presentation ranging from painless chancre, constitutional symptoms, adenopathy, rash, synovitis, neurological, and ocular findings. Syphilis-related bone and joint involvement is usually found in congenital form, but it can also be seen in adults with acquired syphilis as a rare sequela of infectious syphilis. We report a case of a patient diagnosed as rheumatoid arthritis, who presented to the ophthalmology outpatient department with an acute onset of black spots in his visual field, whose clinical examination was a diagnostic dilemma, for which the patient underwent extensive investigations and was diagnosed to have syphilitic uveitis. In hindsight, it was concluded that the patient was suffering from reactive arthritis due to syphilis.