Robinson, W. Thorax , Saccular aneurysm caused by bacterial endocarditis in a syphilitic aorta. The rapid development of a saccular aneurysm during successfully treated bacterial endocarditis, in an ascending aorta previously affected by syphilis which had been treated with adequate chemotherapy 15 years previously, is described. Although bacterial endocarditis does occasionally complicate syphilitic aortic valve disease, the literature does not contain any report of resulting aneurysm development. The investigation and successful surgical treatment of the case are described.
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Context: Syphilitic aortitis has been relegated to the category of rare cardiovascular disease or a "medical curiosity" in the west. The same situation may not exist in developing countries due to the stigmata that continue to remain attached to sexually-transmitted diseases in general. Aims: To study the prevalence of syphilitic aortitis among autopsied non-atherosclerotic aortic diseases encountered in a span of 15 years.
Settings and Design: Retrospective, autopsy-based study. Materials and Methods: Among cases of non-atherosclerotic diseases of the aorta, 44 had been diagnosed as syphilitic aortitis on the basis of the pathological features and serology.
The demographic details and modes of clinical presentation were retrieved from the health records. Depending on the presence of complicating lesions, the cases were classified as uncomplicated or complicated aortitis. Results: The 44 cases of syphilitic aortitis formed They were predominantly seen in males in the fifth decade, who often presented with valvular regurgitation, aneurysmal disease or myocardial ischemia; Blood VDRL results were available in 19 patients; Concomitant involvement of the ascending, transverse and descending thoracic was seen in None had uncomplicated aortitis.
Complications in the form of aortic regurgitation Conclusions: We found syphilitic aortitis to be a common cause of aortitis at autopsy. Diagnosis should be made with the help of characteristic pathological features correlated to the clinical context and appropriate serological tests. Cabero Moyano,M. Andreu Magarolas,E. Verberne Clinical Rheumatology. Current Problems in Surgery. Johnston Journal of the Neurological Sciences.
Katabathina,Carlos S. Syphilitic aortitis: Rearing of the ugly head. How to cite this article: Vaideeswar P. Indian J Pathol Microbiol ; Materials and Methods. Figure 1 : a Classic tree-barking, multiple gelatinous plaques, separated by stellate scars and vertical furrows, seen in the ascending aorta and arch. The arrow points at the perivascular inflammatory infiltrate rich in plasma cells. Table 1 :Non-atherosclerotic aortic diseases Click here to view.
Figure 2 : a Aortitis restricted to the ascending aorta. There is annular dilatation and commissural separation, especially the one between the non-coronary and right coronary cusps black arrow. There was clinical valvular regurgitation. White arrows indicate ostial stenosis, right more than the left MV mitral valve, LV left ventricle ; b Commonest pattern of involvement, tree-barking seen in the ascending, arch and descending thoracic segments Click here to view.
Figure 3 :Syphilitic aortitis affecting the three segments of the aorta. Note marked atherosclerosis with ulceration in the thoracic portion. The patient, 45 years male, presented with peripheral vascular disease Click here to view. Figure 5 :The heart has been cut longitudinally to show a saccular protrusion in the proximal ascending aorta arrows with a larger fusiform aneurysm involving the remaining portion Click here to view.
On the origin of the treponematoses: a phylogenetic approach. Cardiovascular syphilis. Am J Med ; Aortocaval fistula: a rare complication of abdominal aortic aneurysm. Indian Heart J ; Bhaskara Reddy D, Ranganayakamma I. Syphilitic aortitis A clinico-pathologic and autopsy study of 32 cases during the year period from to Cheng TO. Syphilitic aortitis is dying but not dead.
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Penetrating ulcer of ascending thoracic aorta in syphilis. Sexual and treatment behaviour of STD patients. Indian J Sex Transm Dis ;13; Syphilis in an urban community. Can J Public Health ; Syphilitic or systemic lupus erythematosus. Am J Clin Pathol ; Barking up the wrong tree? Use of polymerase chain reaction to diagnose syphilitic aortitis.
Thorax ; This article has been cited by. Transient aortitis documented by positron emission tomography in a case series of men and transgender women infected with syphilis. Syphilitic aortic aneurysm with a pulmonary lesion: a case report and literature view. A case of syphilitic aortic aneurysm with sternal erosion and impending rupture.
Asian Cardiovascular and Thoracic Annals. Belmonte Castan. Nonurgent aortic disease: Clinical-radiological diagnosis of aortitis. Syphilitic aortic aneurysm with spastic paraparesis: A novel presentation and review of the literature. Search Pubmed for Vaideeswar P. Search in Google Scholar for Vaideeswar P. Related articles Aortic aneurysm aortic regurgitation aortitis cardiovascular syphilis.
Materials and Me Article Figures. Article Tables.
Saccular aneurysm caused by bacterial endocarditis in a syphilitic aorta
Open Access Peer-Reviewed. Rev Bras Cir Cardiovasc. View article. An Bras Dermatol. Carrada-Bravo T.
This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Postmortem examination of bodies at the institute of the Faculty of Medicine in Buenos Aires shows that 20 per cent of cardiovascular lesions are of syphilitic origin. In other countries the proportion is lower, as the following figures seem to indicate: United States, 10 per cent; Germany, 6 per cent, and England, 5 per cent. The greater incidence in Buenos Aires is ascribed to a failure in the early diagnosis coupled with inadequate and incorrect therapy. With these facts in mind, the author has admirably set forth the pathologic anatomy, diagnostic criteria and roentgenologic aspects of syphilitic aortitis. This monograph is concise, clear and to the point; numerous illustrations enhance the value of the book.
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