{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T03:03:32Z","timestamp":1771297412725,"version":"3.50.1"},"reference-count":20,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,5,10]]},"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:p>Idiopathic intracranial hypertension (IIH) is being diagnosed more often in the UK due to the rise in obesity. In fact, patients who present with bilateral optic disc swelling are habitually put on the papilloedema pathway, often without consideration of other diagnoses. We report the case of a middle-aged woman diagnosed with papilloedema and managed as IIH, until, cerebrospinal fluid (CSF) analysis revealed evidence of lymphocytic meningitis secondary to syphilis. The patient was treated successfully with intravenous antibiotics. Syphilis is the great masquerader and should be a diagnosis to consider in patients who have CSF findings incongruent with their clinical presentation.<\/jats:p>","DOI":"10.1136\/bcr-2020-239813","type":"journal-article","created":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T13:43:08Z","timestamp":1621431788000},"page":"e239813","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Bilateral optic disc swelling resulting from lymphocytic meningitis and posterior uveitis secondary to syphilis"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2942-3635","authenticated-orcid":false,"given":"Sunil","family":"James","sequence":"first","affiliation":[{"name":"Acute Medical Unit, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karunakaran Pradeep","family":"Thozhuthumparambil","sequence":"additional","affiliation":[{"name":"Acute Medical Unit, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,5,19]]},"reference":[{"key":"2025082801570440000_14.5.e239813.1","doi-asserted-by":"publisher","DOI":"10.1136\/practneurol-2014-000821"},{"key":"2025082801570440000_14.5.e239813.2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2008.01324.x"},{"key":"2025082801570440000_14.5.e239813.3","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-020-05155-8","article-title":"Clinical features of aseptic meningitis with varicella zoster virus infection diagnosed by next-generation sequencing: case reports","volume":"20","author":"Chen","year":"2020","journal-title":"BMC Infect Dis"},{"key":"2025082801570440000_14.5.e239813.4","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.61.10.1553"},{"key":"2025082801570440000_14.5.e239813.5","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e31822e8e68"},{"key":"2025082801570440000_14.5.e239813.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(99)80042-4"},{"key":"2025082801570440000_14.5.e239813.7","doi-asserted-by":"crossref","DOI":"10.1186\/1752-1947-2-86","article-title":"Pseudo-foster Kennedy syndrome due to unilateral optic nerve hypoplasia: a case report","volume":"2","author":"Bansal","year":"2008","journal-title":"J Med Case Rep"},{"key":"2025082801570440000_14.5.e239813.8","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.101937"},{"key":"2025082801570440000_14.5.e239813.9","doi-asserted-by":"publisher","DOI":"10.1007\/s00417-006-0494-0"},{"key":"2025082801570440000_14.5.e239813.10","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.1001\/archopht.119.9.1299","article-title":"Optic perineuritis: clinical and radiographic features","volume":"119","author":"Purvin","year":"2001","journal-title":"Arch Ophthalmol"},{"key":"2025082801570440000_14.5.e239813.11","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.survophthal.2014.11.004","article-title":"Optic nerve lymphoma: report of two cases and review of the literature","volume":"60","author":"Kim","year":"2015","journal-title":"Surv Ophthalmol"},{"key":"2025082801570440000_14.5.e239813.12","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1159\/000501302","article-title":"Unusual primary ocular manifestation of sarcoidosis","volume":"10","author":"Deuchler","year":"2019","journal-title":"Case Rep Ophthalmol"},{"key":"2025082801570440000_14.5.e239813.13","doi-asserted-by":"crossref","DOI":"10.5694\/j.1326-5377.2009.tb02766.x","article-title":"Syphilitic perioptic neuritis mimicking papilloedema","volume":"191","author":"Low","year":"2009","journal-title":"Med J Aust"},{"key":"2025082801570440000_14.5.e239813.14","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2019-232520","article-title":"Neurosyphilis presenting as visually asymptomatic bilateral optic perineuritis","volume":"12","author":"Yosar","year":"2019","journal-title":"BMJ Case Rep"},{"key":"2025082801570440000_14.5.e239813.15","doi-asserted-by":"crossref","first-page":"171","DOI":"10.3201\/eid2601.191122","article-title":"Diagnosis of syphilitic bilateral papillitis mimicking papilloedema","volume":"26","author":"Gonzalez-Martinez","year":"2020","journal-title":"Emerg Infect Dis"},{"key":"2025082801570440000_14.5.e239813.16","article-title":"The great Masquerader: syphilis mimicking papilledema and traction alopecia","volume":"12","author":"McNally","year":"2020","journal-title":"Cureus"},{"key":"2025082801570440000_14.5.e239813.17","doi-asserted-by":"crossref","DOI":"10.1136\/bcr.09.2011.4813","article-title":"Syphilis mimicking idiopathic intracranial hypertension","volume":"2011","author":"Yri","year":"2011","journal-title":"BMJ Case Rep"},{"key":"2025082801570440000_14.5.e239813.18","doi-asserted-by":"crossref","first-page":"e641","DOI":"10.1111\/aos.13963","article-title":"The great imitator on the rise: ocular and optic nerve manifestations in patients with newly diagnosed syphilis","volume":"97","author":"Klein","year":"2019","journal-title":"Acta Ophthalmol"},{"key":"2025082801570440000_14.5.e239813.19","doi-asserted-by":"crossref","first-page":"193","DOI":"10.3201\/eid2402.171167","article-title":"Increase in ocular syphilis cases at ophthalmologic reference center, France, 2012-2015","volume":"24","author":"Pratas","year":"2018","journal-title":"Emerg Infect Dis"},{"key":"2025082801570440000_14.5.e239813.20","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1097\/00019048-199605000-00014","article-title":"Red herrings in infectious diseases","volume":"5","author":"Karim","year":"1996","journal-title":"Infectious Diseases in Clinical Practice"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-239813","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:57:14Z","timestamp":1756371434000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-239813"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5]]},"references-count":20,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,5,19]]},"published-print":{"date-parts":[[2021,5]]}},"alternative-id":["10.1136\/bcr-2020-239813"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-239813","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5]]}}}