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Case Report: Syphilitic proximal coronary stenosis with discordant serology: diagnostic validation by optical

Jingjie Xiong1,2,3, Ting Gan4, Jing Hu5

  • 1Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Frontiers in Medicine
|November 27, 2025
PubMed

Insights

Cardiovascular syphilis diagnosis is challenging, especially with conflicting serology. Optical coherence tomography (OCT) identified syphilitic vasculitis in coronary stenosis, guiding treatment when atherosclerosis was absent.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Vascular Medicine

Background:

  • Cardiovascular syphilis, a late manifestation of Treponema pallidum infection, presents diagnostic challenges, particularly with discordant serological tests.
  • Non-atherosclerotic coronary artery stenosis requires accurate etiological diagnosis for effective treatment.
  • Syphilitic aortitis and coronary involvement can mimic or coexist with atherosclerosis.

Keywords:
Treponema pallidumaortitisdiscordant serologyintravascular imagingoptical coherence tomographyproximal coronary stenosissyphilitic vasculitis

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