Syphilitic Aortitis in Secondary Syphilis

Dietrich, A.; Gauglitz, Gerd G.; Pfluger, Thomas; Herzinger, Thomas; Braun‐Falco, Markus

doi:10.1001/jamadermatol.2013.9537

Cited by 14 publications

(8 citation statements)

References 7 publications

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“…[5] Two cases of secondary syphilis presented with generalized lymphadenopathy, and one of them also had asymptomatic neurosyphilis. [1415] Three cases were syphilis with pulmonary involvement,[161718] one was syphilitic osteomyelitis,[19] one was syphilitic aortitis,[20] and one was syphilitic hepatitis. [21]…”

Section: Resultsmentioning

confidence: 99%

“…[7131420] There were three cases, in which PET was used to rule out paraneoplastic limbic encephalitis or malignancy. [313840] In one case with aortic aneurysm, PET was carried out to exclude active vasculitis.…”

Section: Resultsmentioning

confidence: 99%

“…The majority of the case reports found that a PET scan was useful for characterizing the disease extent, especially in generalized lymphadenopathy, syphilitic aortitis, and neurosyphilis with dementia,[3712142022232425283032333839] with the exception being cases in which the PET scan showed no pathological glucose uptake. [2731]…”

Section: Resultsmentioning

confidence: 99%

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Usefulness of Positron Emission Tomography in Patients with Syphilis

Chen

Zheng

Liu

2017

Chinese Medical Journal

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Background:Diagnosis of syphilis is difficult. Follow-up and therapy evaluation of syphilitic patients are poor. Little is known about positron emission tomography (PET) in syphilis. This review was to systematically review usefulness of PET for diagnosis, disease extent evaluation, follow-up, and treatment response assessment in patients with syphilis.Methods:We searched PubMed, EMBASE, SCOPUS, Cochrane Library, Web of Science, ClinicalTrials.gov, and three Chinese databases (SinoMed, Wanfang, and CNKI) for English and Chinese language articles from inception to September 2016. We also collected potentially relevant studies and reviews using a manual search. The search keywords included the combined text and MeSH terms “syphilis” and “positron emission tomography”. We included studies that reporting syphilis with a PET scan before and/or after antibiotic treatment. The diagnosis of syphilis was based on serological criteria or dark field microscopy. Outcomes include pre- and post-treatment PET scan, pre- and post-treatment computed tomography, and pre- and post-treatment magnetic resonance imaging. We excluded the articles not published in English or Chinese or not involving humans.Results:Of 258 identified articles, 34 observational studies were included. Thirty-three studies were single-patient case reports and one study was a small case series. All patients were adults. The mean age of patients was 48.3 ± 12.1 years. In primary syphilis, increased fluorodeoxyglucose (FDG) accumulation could be seen at the site of inoculation or in the regional lymph nodes. In secondary syphilis with lung, bone, gastrointestinal involvement, or generalized lymphadenopathy, increased FDG uptake was the most commonly detected changes. In tertiary syphilis, increased glucose metabolic activity, hypometabolic lesions, or normal glucose uptake might be seen on PET. There were five types of PET scans in neurosyphilis. A repeated PET scan after treatment revealed apparent or complete resolution of the asymmetry of radiotracer uptake.Conclusion:PET is helpful in targeting diagnostic interventions, characterizing disease extent, assessing nodal involvement, and treatment efficacy for syphilis.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Usefulness of Positron Emission Tomography in Patients with Syphilis

Chen

Zheng

Liu

2017

Chinese Medical Journal

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“…These technologies can give a new insight into rare presentations of syphilis such as aortitis and help in differentiating it from alternate aetiologies, especially when the location is infrequent (e.g. : descending aorta) [11]. These technologies have already demonstrated utility in aortitis with a rheumatologic origin such as Takayasu arteritis and Giant Cell Arteritis where FDG PET is a reliable marker for inflammation while CT and MRI provide more precise anatomic localisation [12].…”

Section: Discussionmentioning

confidence: 99%

A case report of CT-diagnosed renal infarct secondary to syphilitic aortitis

Spaltenstein

et al. 2017

BMC Infect Dis

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BackgroundEven though reported cases of syphilis have been increasing, cases of tertiary syphilis remain extremely rare. The majority of our knowledge with regard to complications of syphilis such as aortitis was acquired before the advent of relatively modern technologies such as CT, MRI and PET. This case report presents a rare case of syphilitic aortitis associated with a renal infarct caused by a peripheral arterial embolism diagnosed by CT.Case presentationWe present a young man with sudden abdominal pain and flank tenderness without fever. Blood tests showed acute kidney failure. Computed tomography showed a right renal infarct and a non-circular thickening of the descending thoracic aortic wall with intra-luminal thrombus. Serology confirmed the diagnosis of syphilis. Treatment with anticoagulant and penicillin resulted in a good outcome. Follow-up PET-MRI showed resolution of the thrombus with a metabolically inactive atheromatous plaque.ConclusionTechnologies, such as CT, PET-CT and PET-MRI, that were not present during the pre-antibiotic era, can provide new insights into rare presentations of tertiary syphilis such as aortitis. These imaging modalities show promise for early radiological diagnosis of aortitis in syphilis and may be useful for determining the response to treatment in specific cases.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2624-1) contains supplementary material, which is available to authorized users.

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“…Late latent syphilis is the asymptomatic period after 1 year and can last from months to years . Lastly, tertiary syphilis is the late symptomatic period, and it can involve the skin, bones, soft tissues, the nervous and cardiovascular system, with findings such as: destructive syphilitic gummas, hemiparesis, aphasia, seizures, aortitis, aortic aneurysms, myocardial infarction and congestive heart failure …”

Section: Introductionmentioning

confidence: 99%

Late latent mucinous syphilis mimicking connective tissue disease

Gottesman

Schoenling²,

Culpepper

2017

J Cutan Pathol

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As evidenced by the Centers for Disease Control and Prevention (CDC) statistics, syphilis is yet again on the rise. It is known as the great mimicker because of its variable symptoms and how frequently it can be confused with other diseases. The different stages of syphilis (primary, secondary, latent, late latent and tertiary) are discussed. We describe a new histopathologic pattern of syphilis, one that mimics connective tissue disease and can represent a diagnostic pitfall. In this time and age, when syphilis is rising especially among the men who have sex with men subgroup, it is important to keep a high index of suspicion of syphilis even when clinically and histopathologically the findings on first glance may not appear characteristic.

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Syphilitic Aortitis in Secondary Syphilis

Cited by 14 publications

References 7 publications

Usefulness of Positron Emission Tomography in Patients with Syphilis

Usefulness of Positron Emission Tomography in Patients with Syphilis

A case report of CT-diagnosed renal infarct secondary to syphilitic aortitis

Late latent mucinous syphilis mimicking connective tissue disease

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