Chronic syphilitic aortic aneurysm complicated with chronic aortic dissection.
BACKGROUND
Historically, tertiary syphilis infection has been the most common cause of thoracic aortic aneurysm, resulting in 5% to 10% of cardiovascular deaths until the era of antibiotics.


METHODS
A 49-year-old Caucasian man presented to our institution with progressive dysphagia, weight loss, incomplete bladder emptying, alcohol and tobacco consumption, systemic arterial hypertension, Argyll Robertson pupil, leg paresthesias, and mediastinal widening. He was admitted to investigate clinical alterations. Thoracic computed tomography revealed an aortic aneurysm complicated with chronic aortic dissection from the ascending aorta to the iliac vessels with 2 communicating lumens. Cerebrospinal fluid examination tested positive for neurosyphilis in a venereal disease research laboratory test (titre 1/32).


RESULTS
Chronic syphilitic aortic aneurysm complicated with chronic aortic dissection was diagnosed.


CONCLUSIONS
This is a unique presentation of a syphilitic infection. Syphilitic aortitis, the hallmark of cardiovascular syphilis, has become rare and is hardly considered by today's clinicians in their differential diagnosis.
Cruz
Ricardo Pedrini
RP
Surgery Department, Medical University of Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil. rpcruz2004@gmail.com
Marrone
Luiz Carlos Porcello
LC
Marrone
Antônio Carlos Huf
AC
D000784:Aortic Dissection / Q000175:diagnosis / Q000209:etiology*; D000785:Aneurysm, Infected / Q000175:diagnosis / Q000209:etiology*; D000907:Antibodies, Bacterial / Q000032:analysis; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000209:etiology*; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013589:Syphilis, Cardiovascular / Q000150:complications* / Q000175:diagnosis; D014057:Tomography, X-Ray Computed; D014210:Treponema pallidum / Q000276:immunology
D000907:Antibodies, Bacterial