What stage of syphilis is characterized by syphilitic aortitis?

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From the Guidelines

Syphilitic aortitis is characterized by tertiary syphilis.

Key Characteristics of Syphilitic Aortitis

  • It typically occurs 10 to 25 years after the initial spirochetal infection 1
  • The ascending thoracic aorta is most often involved 1
  • It is a late complication of syphilis, which is caused by the bacterium Treponema pallidum

Diagnosis and Management

  • Syphilitic aortitis is a rare cause of thoracic aortic aneurysms 1
  • Infection most often arises in a diseased aorta, either in a preexisting aneurysm, at the site of an atherosclerotic plaque, or at the site of some accidental or iatrogenic aortic trauma 1
  • The diagnosis of syphilis is typically made using serologic tests, such as the rapid plasma reagin (RPR) test or the fluorescent treponemal antibody absorption (FTA-ABS) test 1
  • Treatment of syphilis typically involves the use of antibiotics, such as penicillin 1

Clinical Considerations

  • Syphilitic aortitis can lead to serious complications, including aortic aneurysm formation and rupture 1
  • It is essential to diagnose and treat syphilis promptly to prevent long-term complications, including syphilitic aortitis 1

From the Research

Syphilitic Aortitis Stage

  • Syphilitic aortitis is characterized by the tertiary stage of syphilis, as indicated by studies 2, 3, 4, 5
  • This stage is marked by various cardiovascular manifestations, including aortic regurgitation, dilatation of the ascending aorta, and ostial coronary artery lesions 2, 3, 4
  • Although aortitis is typically associated with tertiary syphilis, there have been rare cases reported in secondary syphilis, as seen in the study 6
  • The tertiary stage of syphilis can lead to severe complications, such as aortic aneurysm, aortic valvular insufficiency, aortic root dilation, and coronary ostial stenosis 3, 4

Key Characteristics

  • Syphilitic aortitis is often characterized by aortic regurgitation, dilatation of the ascending aorta, and ostial coronary artery lesions 2, 3, 4
  • The condition can lead to severe complications, including aortic aneurysm, aortic valvular insufficiency, and coronary ostial stenosis 3, 4
  • Diagnosis and treatment of syphilitic aortitis require a multidisciplinary approach, as seen in the study 6

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

ST Segment Elevation Myocardial Infarction Due to Severe Ostial Left Main Stem Stenosis in a Patient with Syphilitic Aortitis.

Romanian journal of internal medicine = Revue roumaine de medecine interne, 2016

Research

Cardiovascular Syphilis.

Cardiology in review, 2025

Research

Syphilitic aortitis and its complications in the modern era.

Giornale italiano di dermatologia e venereologia : organo ufficiale, Societa italiana di dermatologia e sifilografia, 2018

Research

Syphilitic aortitis: diagnosis and treatment. Case report.

Revista brasileira de cirurgia cardiovascular : orgao oficial da Sociedade Brasileira de Cirurgia Cardiovascular, 2010

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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