Syphilis—Cardiovascular Manifestations of the Great Imitator

Abstract

Rates of syphilis are beginning to once again increase, with the World Health Organization estimating that in recent years there were 12 million new cases of syphilis each year; in 2002, syphilis was responsible for 0.3% of deaths globally. At-risk groups include young males (20-29 years), prisoners, and sex workers. Increased rates in young females have elevated the numbers of congenital cases. Review of the University of Adelaide Pathology Archive revealed four cases with significant pathology, which included cardiac gummas and aortic arch aneurysms. These cases demonstrate the cardiovascular characteristics of untreated syphilis in the tertiary stage. Cases with such advanced pathology will only occur where diagnoses have not been made, and/or standard antibiotic therapy has not been implemented in the early stage of disease.

Chemerin induced by Treponema pallidum predicted membrane protein Tp0965 mediates the activation of endothelial cell via MAPK signaling pathway

“…Cardiovascular syphilis is associated with multiple clinical syndromes, of which aortic aneurysms, aortic insufficiency, and coronary artery stenosis are the most common. 2,3 These clinical presentations are similar to other, more common varieties of cardiac disease. At the beginning of the inflammatory process following infection by T. pallidum, the insult is primarily to the small nutrient vessels of the aorta, but by later stage all three layers of aortic wall are affected.…”

Aortitis sifilítica: a propósito de un caso del sur colombiano

“…En todo el mundo se ha observado un reciente aumento de esta enfermedad y su causa es multifactorial, en la que se incluyen una mayor actividad sexual de alto riesgo y sin protección, la migración y los cambios sociales, que disminuyen la oportunidad y la accesibilidad a los servicios de salud para un tratamiento precoz y oportuno. Sin embargo, los regímenes terapéuticos actualmente están bien definidos y son exitosos 9 ; como primera línea de tratamiento está la penicilina, que se usó en la paciente antes de la intervención quirúrgica a dosis de 2,400,000 UI por vía intramuscular semanal, por 3 semanas.…”

“…La sífilis terciaria puede ocurrir en aproximadamente un tercio de los pacientes no tratados y causar lesiones granulomatosas, llamadas gomas; entre otras manifestaciones se encuentran las cardiovasculares y las neurológicas. Hoy día es raro encontrar este tipo manifestaciones por el éxito de los antibióticos, pero esta infección puede desarrollarse a largo plazo (años y tal vez décadas) después de la infección inicial sin el apropiado manejo, llegando a observarse hasta en el 70% de los pacientes no tratados 4,5,9,10 .…”

Pregnancy syphilis epidemic trends, clinical features, APOs risk factors, pregnancy-induced hypertension epidemics and related factors, in Northeast China Jilin Maternity Hospital 2013-2017

“…We think this may be due to syphilis infection. Novikov Iu has found that syphilis can cause small blood vessel inflammation [45,46]. And an excessive maternal innate immune response is sufficient to cause vascular inflammation and endothelial dysfunction, which contributes to the development of pregnancy hypertension during pregnancy [47][48][49].…”