title: Asymptomatic syphilitic massive necrosis of the spleen in late syphilis.
abstract: The varieties of luetic clinical variants are countless in nature. In this regard, an autopsy case of a 72-year-old homeless man who accidentally succumbed to carbon-monoxide poisoning is here presented and reviewed. The autopsy revealed the highly unusual finding of asymptomatic syphilitic necrosis of spleen followed by luetic mesaortitis, a solitary skin gumma, and syphilitic arthritis. The spleen was 8×4×3 cm in size; the capsule was completely calcified and firm, 3 to 5 mm thick. Only in the region of the hilus was a small part of preserved tissue found. After puncturing the capsule, a brown-yellowish pus-like mass was found which filled the entire space inside. When reviewing the relevant literature, this case and its finding of pan splenic necrosis accompanied by a calcified capsule seem to be unique in nature. In terms of the final diagnosis, a Treponema pallidum haemagglutination assay confirmed it to be syphilis. Since it was a late stage of the disease, it is estimated that it may have been present for more than 20 or 30 years in the deceased.
authors: Department of Forensic Medicine, Clinical Centre of Montenegro, Faculty of Medicine, University of Montenegro, Podgorica, Montenegro.
authors: Nemanja
authors: N
authors: Radojevic
authors: Filip
authors: F
authors: Vukmirovic
authors: Ivana
authors: I
authors: Curovic
authors: Miodrag
authors: M
authors: Soc
mesh_terms: D000368:Aged; D001344:Autopsy; D006801:Humans; D008297:Male; D009336:Necrosis / Q000473:pathology*; D013154:Spleen / Q000473:pathology*; D013587:Syphilis / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D014209:Treponema Immobilization Test; D014210:Treponema pallidum / Q000302:isolation & purification*
keywords: Spleen necrosis; Treponema pallidum; mesaortitis; splenic; splenitis; syphilis