Cardiovascular syphilis

Jackman, John D.; Radolf, Justin D.

doi:10.1016/s0002-9343(89)80826-5

Cited by 135 publications

(49 citation statements)

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“…4 It is exceedingly rare in secondary syphilis, as seen in our patient. It often is an incidental radiologic finding, and signs of infection (eg, fever and leukocytosis) are often missing.…”

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confidence: 52%

Syphilitic Aortitis in Secondary Syphilis

et al. 2014

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Syphilis is a mainly sexually transmitted infection that may show a variety of symptoms at various stages. Syphilitic aortitis is a known complication of tertiary syphilis and can cause aneurysm of the aorta. 1 In the era of antibiotics, cardiovascular syphilis has become very rare. 2 Nevertheless it can cause life-threatening or even fatal symptoms and should therefore be diagnosed at an early stage. 3 outcome. 5,6

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confidence: 52%

Syphilitic Aortitis in Secondary Syphilis

et al. 2014

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“…Complications occur in approximately 10% of individuals with untreated syphilis (160), the most common being aortic regurgitation. Other complications are coronary ostial stenosis and saccular aneurysm (153). Recently, PCR methods have detected T. pallidum DNA in an aortic aneurysm (223), confirming that damage results from actual infection of the aorta.…”

Section: Tertiary Syphilismentioning

confidence: 89%

Biological Basis for Syphilis

2006

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SUMMARY Syphilis is a chronic sexually transmitted disease caused by Treponema pallidum subsp. pallidum. Clinical manifestations separate the disease into stages; late stages of disease are now uncommon compared to the preantibiotic era. T. pallidum has an unusually small genome and lacks genes that encode many metabolic functions and classical virulence factors. The organism is extremely sensitive to environmental conditions and has not been continuously cultivated in vitro. Nonetheless, T. pallidum is highly infectious and survives for decades in the untreated host. Early syphilis lesions result from the host's immune response to the treponemes. Bacterial clearance and resolution of early lesions results from a delayed hypersensitivity response, although some organisms escape to cause persistent infection. One factor contributing to T. pallidum's chronicity is the paucity of integral outer membrane proteins, rendering intact organisms virtually invisible to the immune system. Antigenic variation of TprK, a putative surface-exposed protein, is likely to contribute to immune evasion. T. pallidum remains exquisitely sensitive to penicillin, but macrolide resistance has recently been identified in a number of geographic regions. The development of a syphilis vaccine, thus far elusive, would have a significant positive impact on global health.

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“…1 It is known to be associated with a variety of systemic vasculitides (most commonly giant cell arteritis 2,3 and Takayasu's arteritis 3,4 ), other systemic inflammatory diseases such as rheumatoid arthritis, 5 systemic lupus erythematosus, 6 ankylosing spondylitis 7 and infections (especially bacterial infections, syphilis 8 and tuberculosis 9 ). In a substantial fraction of cases, aortitis is diagnosed in patients with no history or clinical symptoms of a systemic disease.…”

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confidence: 99%

A case series of surgically diagnosed idiopathic aortitis in a Canadian centre: a retrospective study

et al. 2017

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Background: Idiopathic aortitis became recognized relatively recently, and the body of knowledge concerning this condition is scarce. We aimed to determine the frequency of idiopathic aortitis in aortic specimens, the clinical, laboratory and radiologic characteristics at diagnosis and during follow-up, and the approach to investigation, treatment and monitoring taken by the treating physicians. Methods:We identified cases of aortitis diagnosed on pathological specimens of the aorta between Jan. 1, 2003, and July 31, 2013, at The Ottawa Hospital by reviewing the hospital's pathology database. Charts of identified patients were reviewed, and data on patient demographic characteristics, clinical features, laboratory and imaging tests, treatment and outcomes were analyzed.Results: A total of 684 aortic specimens were analyzed during the study period; 47 cases of aortitis were identified, 32 of which were idiopathic. Twenty-one patients (66%) had complete imaging of branch vessels at baseline, 16 (76%) of whom had additional aortic or branch vessel lesions. Twelve patients (38%) received corticosteroids postoperatively. Over a mean follow-up period of 47.5 months, among the 12 patients (38%) who had complete imaging of branch vessels at least once, new aortic or branch lesions were diagnosed in 5 (42%); 3/32 patients (9%) required additional vascular surgery; and a new systemic condition was diagnosed in 2/32 (6%).Interpretation: Idiopathic aortitis is commonly discovered incidentally on examination of the pathological specimen following ascending aortic aneurysm repair. No guidelines exist for the investigation, treatment and follow-up of this condition, resulting in great variability of practice. Good-quality prospective studies are needed to address the many unanswered clinical questions regarding idiopathic aortitis and to allow formulation of more definitive recommendations. Abstract ResearchResearch CMAJ OPEN E484CMAJ OPEN, 5(2)

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Cardiovascular syphilis

Cited by 135 publications

References 0 publications

Syphilitic Aortitis in Secondary Syphilis

Syphilitic Aortitis in Secondary Syphilis

Biological Basis for Syphilis

A case series of surgically diagnosed idiopathic aortitis in a Canadian centre: a retrospective study

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