Case report:

A 59-year-old woman with nodular scleritis without improvement after oral treatment with non-steroidal anti-inflammatory drugs, and oral and topical corticosteroids. Tests were performed finding reactive VDRL in 32 dls and reactive FTA-ABS. A lumbar puncture evidenced pleocytosis. Nodular scleritis secondary to neurosyphilis was diagnosed and treatment with intravenous penicillin was initiated, showing improvement of scleral inflammation.

Discussion:

Scleritis due to syphilis is uncommon, and even more so if it is the only ocular manifestation. In addition, most reports of scleritis as a manifestation of syphilis have been described in people with HIV infection, but our patient was not immunocompromised, and HIV serology was negative.

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