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Classical syphilitic lesions from the museum
1School of Medicine, The University of Adelaide, Level 2 Medical School North Building, Frome Rd, Adelaide, SA, 5005, Australia. roger.byard@sa.gov.au.
Insights
Syphilis, a sexually transmitted infection, can cause severe cardiovascular and neurological damage over decades without treatment. This review highlights three cases of advanced syphilis, emphasizing the need for clinical awareness of its classical manifestations.
Area of Science:
- Medicine
- Pathology
- Infectious Diseases
Background:
- Syphilis is a complex venereal disease with a protracted, multi-stage progression.
- Increasing diagnoses necessitate a review of its diverse clinical presentations.
- The Faculty of Medicine at The University of Adelaide's Pathology Museum archives provide historical case data.
Observation:
- Three cases with distinct cardiovascular and neurological sequelae of untreated syphilis were identified.
- Case 1: Aortic aneurysm (ascending and descending aorta) in an 80-year-old male.
- Case 2: Chronic syphilitic meningoencephalitis with cerebral atrophy in a 56-year-old male.
- Case 3: Tabes dorsalis in a 77-year-old male.
Findings:
- The cases demonstrate classical late-stage manifestations of syphilis.
- Cardiovascular syphilis presented as aortic aneurysms.
- Neurosyphilis manifested as meningoencephalitis and tabes dorsalis.
Implications:
- Rising syphilis incidence, driven by various factors, requires heightened clinical suspicion.
- Recognition of classical syphilitic findings is crucial for timely diagnosis and management.
- Understanding these manifestations is vital for potential medicolegal evaluations.
Abstract:
Syphilis is an increasingly diagnosed venereal disease which has four distinctive stages that may last over decades if appropriate treatment is not given. Review of the files of the Pathology Museum in the Faculty of Medicine at The University of Adelaide revealed three cases with classical cardiovascular and neurological findings. Case 1: An 80-year-old man with a large syphilitic aneurysm of the ascending aorta with a smaller aneurysm of the proximal descending aorta. Case 2: A 56-year-old man with chronic syphilitic meningoencephalitis with cerebral atrophy. Case 3: A 77-year-old man with tabes dorsalis. Given the increase in cases coming to medical attention in recent years due to high-risk sexual activity, migration, travel and reduced access to medical treatment, an awareness of the classical features of syphilis is appropriate as some cases will undoubtedly require medicolegal evaluation.
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