Dilated Tonic Pupils with Tabes Dorsalis in Neurosyphilis as First Manifestation of HIV/AIDS: A Video Report

March 2018 in “ BMJ case reports ”

Antonio José Reyes, Kanterpersad Ramcharan, Samuel Aboh, Stanley Giddings

diffuse hair loss neurosyphilis HIV/AIDS tabes dorsalis

TLDR Dilated pupils can be an early sign of HIV/AIDS.

A 30-year-old bisexual African man presented with weight loss, shooting pains, paraesthesia, and difficulty walking, but no significant visual symptoms. Despite normal visual acuity and ocular motility, his pupils were dilated and unreactive to light or accommodation. He exhibited generalized wasting, cervical lymphadenopathy, and diffuse hair loss. His Mini-Mental State Examination and Glasgow Coma Scale were normal. This case highlighted dilated tonic pupils with tabes dorsalis in neurosyphilis as the first manifestation of HIV/AIDS.

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