Ocular syphilis can present in many ways,1 especially in patients infected with HIV. The protean posterior segment manifestations include necrotising retinitis, retinal vascular occlusion, chorioretinitis, neuroretinitis and exudative retinal detachment.2 Nodular periarteritis, or Kyrieleis plaques, are a well-recognised finding in patients with toxoplasmic retinochoroiditis,3 but have only been reported in one previous case of syphilis. We describe the clinical presentation and treatment of an HIV-seropositive patient who developed Kyrieleis plaques in the setting of diffuse uveitis and syphilitic retinitis.

Case report

A 48-year-old white man who had had HIV for 4 years presented with floaters and blurred vision of 3 weeks duration. The patient also reported evanescent skin …