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[Syphilitic aortic aneurysm. A case report].

A Ben Halima1, Z Ibn Elhadj, W Essmat

  • 1Service de Cardiologie, Hôpital Abderrahmen Mami, 2080 Ariana, Tunisie.

Journal Des Maladies Vasculaires
|May 31, 2006
PubMed
Summary
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This case report highlights a rare instance of tertiary syphilis presenting as a large syphilitic aortic aneurysm in a 65-year-old man. Early diagnosis and treatment are crucial for managing this uncommon cardiovascular complication.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Vascular Surgery

Background:

  • Tertiary syphilis incidence has decreased due to early diagnosis and antibiotic use.
  • Syphilitic aortic aneurysms are now rarely encountered.
  • This case presents a resurgence of a formerly common complication.

Observation:

  • A 65-year-old man presented with dyspnea, cough, and chest discomfort.
  • Physical exam revealed decreased breath sounds; labs showed elevated ESR.
  • Serological tests confirmed syphilis (VDRL 1:32, TPHA 1:2560).

Findings:

  • Imaging revealed a large (132 mm) partially thrombosed saccular aneurysm of the ascending aorta involving the innominate artery.
  • Bronchoscopy showed extrinsic compression of the right upper lobar bronchus.

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  • The aneurysm had a circulating lumen of 53 mm.

    • Implications:

    • This case underscores the importance of considering syphilis in aortic aneurysm diagnosis, even when rare.
    • Successful surgical intervention involved aortic replacement and artery reimplantation.
    • Highlights the need for continued vigilance for tertiary syphilis manifestations.