Postmortem diagnosis of syphilitic aortitis, including serological verification on postmortem blood

304 postmortem blood samples were serologically examined for syphilis at Statens Seruminstitut. Seventy-six percent of the samples were usable and gave clear-cut results (18% positive, 34% negative and 24% borderline). Twenty-four percent were indeterminable. The blood samples originated from 304 medico-legally examined bodies, 301 of whom were autopsied. The indications for the serological examinations were suspicion of syphilitic aortitis (SA) on the basis of the macroscopical appearance of the aorta at the autopsy--or information on earlier syphilis. Ninety-seven cases of SA were verified macro- and microscopically, 53 being lethal. The serological results were positive in half of these 97 cases, negative in 15, borderline in 21 and indeterminable in 12. A little more than half of the 97 cases were known in advance in the nation-wide syphilis index at the State Serum Institute. The variegated findings in the remaining part of the material are discussed. It is concluded that serological examination of postmortem blood may be a valuable adjuvant for the pathologist for the diagnosis of SA and other syphilitic manifestations.