Related Experiment Video
Updated: Jan 11, 2026
An Intact Pericardium Ischemic Rodent Model
Published on: September 2, 2021
Syphilis complicated with pericardial effusion: a case report
Jingtao Ma1, Zhiying Zhang1, Meng Chen1
1Zhejiang Chinese Medical University, Jiaxing, 314001, China.
Background:
Pericardial effusion is a relatively common clinical condition that can be classified into inflammatory and non-inflammatory types, with infection being the most frequent cause. However, syphilis as an etiological factor remains extremely rare.
Case Presentation:
A 76-year-old male was admitted to the hospital due to progressive dizziness and exertional dyspnea. Initial evaluation revealed moderate anemia, elevated inflammatory markers, and imaging-confirmed moderate-to-large pericardial effusion. Despite blood transfusions and empirical therapies (nerve nutrition, diuretics, antibiotics), persistent low-grade fever and worsening effusion necessitated pericardiocentesis, draining 220 mL of light red hemorrhagic exudate. Pericardial fluid analysis demonstrated exudative features, with negative cultures. Notably, syphilis serology revealed strongly positive results (syphilis-specific antibodies 436.62 COI; toluidine red unheated serum test 1:32), further confirmed by elevated syphilis-specific antibodies in pericardial effusion (555.64 COI). The patient denied high-risk sexual behaviors and exhibited no typical syphilitic lesions. After excluding malignancies, autoimmune diseases, and other transmitted infections, latent syphilis complicated with pericardial effusion was diagnosed. Unfortunately, robust evidence, including PCR and histopathological biopsy, is lacking to support the hypothesis that syphilis directly infects the pericardium and leads to pericardial effusion. Treatment with penicillin resulted in the resolution of symptoms and pericardial effusion, with no subsequent recurrence.
Conclusion:
This presentation recommends syphilis testing in patients with unexplained or recurrent pericardial effusions, after excluding more common causes.
Insights
Syphilis infection, though rare, can cause pericardial effusion. This case highlights the importance of syphilis testing in unexplained effusions, as penicillin treatment resolved symptoms and effusion.
Area of Science:
- Cardiology
- Infectious Diseases
- Syphilology
Background:
- Pericardial effusion is common, often caused by inflammation or infection.
- Syphilis is an extremely rare cause of pericardial effusion.
Purpose of the Study:
- To report a rare case of latent syphilis presenting as pericardial effusion.
- To emphasize the importance of considering syphilis in unexplained pericardial effusions.
Main Methods:
- A case presentation of a 76-year-old male with unexplained pericardial effusion.
- Diagnostic workup included pericardial fluid analysis and syphilis serology.
- Treatment with penicillin was administered.
Main Results:
- The patient presented with symptoms of dizziness and dyspnea, with imaging confirming pericardial effusion.
- Syphilis serology was strongly positive in both serum and pericardial fluid.
- Penicillin treatment led to complete resolution of symptoms and effusion.
Conclusions:
- Syphilis should be considered in the differential diagnosis of unexplained or recurrent pericardial effusions.
- Testing for syphilis is recommended after excluding more common etiologies.
- This case underscores the diverse presentations of syphilis.
Related Concept Videos
01:19Pericarditis II: Clinical Features and Diagnostic Tests
01:22Pericarditis I: Introduction
01:17Pericarditis III: Medical Management
01:23Rheumatic Heart Disease I: Introduction
01:25Pericarditis IV: Nursing Management
01:27Myocarditis II: Clinical Features and Diagnostic Tests