Aortic aneurysm in a patient with syphilis-related spinal pain and paraplegia

The tertiary stage of syphilis is nowadays extremely rare, showing predilection for the cardiovascular and nervous systems.
A 57-year-old Caucasian man sought medical assistance due to back pain that evolved to paraplegia of the lower limbs. A thoracic CT scan demonstrated an important aneurysmatic lesion of the descending thoracic aorta causing erosion of the vertebral bodies and VDRL and FTA-abs positivity.
Although rare, syphilitic aortitis, the hallmark of cardiovascular syphilis, should be considered in the differential diagnosis in patients with thoracic aneurysm when in the absence of classic risk factors for atherosclerosis, especially in cases that progress with erosion of vertebral bodies.

REFERENCJE (13)

Deyo RA, Rainville J, Kent DL. What can the history and physical examination tell us about low back pain? JAMA 1992; 268: 760-765.

Google Scholar

Hofmann-Wellenhof R, Domej W, Schmid C, et al. Mediastinal mass caused by syphilitic aortitis. Thorax 1993; 48: 568-569.

Google Scholar

Kampmeier RH, Morgan HJ. The specific treatment of syphilitic aortitis. Circulation 1952; 5: 771-778.

Google Scholar

Varela P, Alves R, Velho G, et al. Two recent cases of tertiary syphilis. Eur J Dermatol 1999; 9: 300-302.

Google Scholar

Jackman JD, Radolf JD. Cardiovascular syphilis. Am J Med 1989; 87: 425-433.

Google Scholar

Tong SY, Haqqani H, Street AC. A pox on the heart: five cases of cardiovascular syphilis. Med J Aust 2006; 184: 241-243.

Google Scholar

Heggtveit HA. Syphilitic aortitis. A clinicopathologic autopsy study of 100 cases, 1950 to 1960. Circulation 1964; 29: 346-355.

Google Scholar

Waikittipong S. Syphilitic aortic aneurysm presenting with upper airway obstruction. Asian Cardiovasc Thorac Ann 2012; 20: 575-577.

Google Scholar

Panday S, Hishikar A, Karbhase J. Rupture of syphilitic aneurysm of ascending aorta into main pulmonary artery: successful emergency repair. J Thorac Cardiovasc Surg 1982; 83: 470-471.

Google Scholar

10.

Kumar V, Robbins SL. Robbins basic pathology. 8th ed. Saunders/Elsevier, Philadelphia 2007.

Google Scholar

11.

Lande A, Berkmen YM. Aortitis: pathologic, clinical and arteriographic review. Radiol Clin North Am 1976; 14: 219-240.

Google Scholar

12.

Rockwell DH, Yobs AR, Moore MB. The Tuskegee study of untreated syphilis; the 30th year of observation. Arch Intern Med 1964; 114: 792-798.

Google Scholar

13.

Leung JS, Mok CK, Leong JC, Chan WC. Syphilitic aortic aneurysm with spinal erosion. Treatment by aneurysm replacement and anterior spinal fusion. J Bone Joint Surg Br 1977; 59: 89-92.

Google Scholar

Copyright: © Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie. This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (https://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.

Wyślij swój artykuł

Archiwum

Dla autorów

Udostępnij

Wyślij mailem

ARTYKUŁ POWIĄZANY

A three-stage concept of spine pathology treatment – a different perspective

ARTYKUŁ ORYGINALNY
Bóle dolnego odcinka kręgosłupa u kobiet po 55. roku życia – analiza patogenetyczna

Badania radiometryczne kręgosłupa i miednicy u chorych na dyskopatię lędźwiową z różnym czasem trwania bólu krzyża

Radiometryczne badania położenia kości krzyżowej u chorych na dyskopatię lędźwiową w wieku do 64. roku życia i powyżej 65. roku życia z przewlekłym bólem krzyża

Co-existence of spina bifida occulta and lumbosacral transitional vertebra in patients presenting with lower back pain

Indeksy