Interstitial keratitis with deep corneal vascularisation (salmon patch), Hutchinson's triad, and saddle-nose deformity in a teenager suggests:

• A Congenital syphilis ✓
• B Herpes simplex keratitis
• C Acquired syphilis with ocular involvement
• D Cogan's syndrome

Explanation

Hutchinson's triad (interstitial keratitis, Hutchinson's teeth, and VIII nerve deafness) with deep stromal vascularisation (ghost vessels after resolution), saddle-nose deformity (destruction of the vomer), and appearance in the second decade of life are the hallmarks of late congenital syphilis (Treponema pallidum). Interstitial keratitis in congenital syphilis is immune-mediated (treponemes are rarely recovered from the cornea). Cogan's syndrome has keratitis with VIII nerve involvement but without the other stigmata.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.