From the Guidelines
Relationship Between Syphilis and Aortic Aneurysm
Syphilis can cause an aortic aneurysm, particularly in the tertiary stage of the disease, known as a syphilitic aneurysm, which typically occurs in the aorta 1. If left untreated, syphilis can lead to serious complications, including aneurysm rupture.
Key Points
- Syphilitic aortitis is a rare but serious complication of syphilis, typically occurring 10 to 25 years after the initial infection 1.
- The ascending thoracic aorta is most often involved in syphilitic aortitis 1.
- Infection of the aorta can lead to aneurysm formation, and syphilis is one of the causes of infectious aortitis 1.
- Monitoring for aneurysm development is crucial, especially in patients with a history of untreated or late-stage syphilis 1.
Recommendation
Patients diagnosed with syphilis should be treated promptly with benzathine penicillin G, administered as 2.4 million units intramuscularly, in a single dose for early stages, and 2.4 million units intramuscularly weekly for 3 weeks for late stages. For patients allergic to penicillin, doxycycline 100 mg orally twice daily for 2 weeks for early stages, and 4 weeks for late stages, can be used as an alternative. Regular follow-up with a healthcare provider and imaging studies, such as echocardiogram or CT scan, may be necessary to detect any potential aneurysm formation. In cases where an aneurysm is detected, surgical intervention may be required to prevent rupture and other complications, with the decision made on a case-by-case basis considering the size and location of the aneurysm and the patient's overall health status.
From the Research
Relationship Between Syphilis and Aortic Aneurysm
The relationship between syphilis and aortic aneurysm is well-documented in various studies 2, 3, 4, 5, 6.
- Syphilis can cause tertiary syphilis, which can lead to the development of aortic aneurysms, particularly in the thoracic aorta.
- The diagnosis of syphilitic aortic aneurysm can be challenging due to its rarity and deceptive clinical presentation 2.
- Untreated syphilis can lead to the development of ascending aortic aneurysms, which can result in high mortality rates if left untreated 2, 3, 4.
Clinical Manifestations
The clinical manifestations of syphilitic aortic aneurysm can vary, including:
- Worsening shortness of breath 2
- Progressive hoarseness 3
- Chest pain 5
- Respiratory distress 4
- Dysphagia, weight loss, and incomplete bladder emptying 6
Diagnosis and Treatment
Diagnosis of syphilitic aortic aneurysm can be made through: