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Classical syphilitic lesions from the museum

  • Roger W. Byard
Lessons from the Museum

Abstract

Syphilis is an increasingly diagnosed venereal disease which has four distinctive stages that may last over decades if appropriate treatment is not given. Review of the files of the Pathology Museum in the Faculty of Medicine at The University of Adelaide revealed three cases with classical cardiovascular and neurological findings. Case 1: An 80-year-old man with a large syphilitic aneurysm of the ascending aorta with a smaller aneurysm of the proximal descending aorta. Case 2: A 56-year-old man with chronic syphilitic meningoencephalitis with cerebral atrophy. Case 3: A 77-year-old man with tabes dorsalis. Given the increase in cases coming to medical attention in recent years due to high-risk sexual activity, migration, travel and reduced access to medical treatment, an awareness of the classical features of syphilis is appropriate as some cases will undoubtedly require medicolegal evaluation.

Keywords

Syphilis Chancre Aortic aneurysm Meningoencephalitis General paralysis of the insane Tabes dorsalis 

Notes

Compliance with ethical standards

Ethical approval

Not required.

Conflict of interest

The author declares that he has no conflicts of interest.

References

  1. 1.
    World Health Organization, Department of Reproductive Health and Research. Prevalence and incidence of selected sexually transmitted infections. Chlamydia trachomatis, Neisseria gonorrhoeae, syphilis and Trichomonas vaginalis. Methods and results used by WHO to generate 2005 estimates. 2011. http://www.who.int/reproductivehealth/publications/rtis/9789241502450/en/. Accessed 19 Jul 2018.
  2. 2.
    Marra CM. Neurosyphilis. Curr Neurol Neurosci Rep. 2004;4:435–40.CrossRefPubMedGoogle Scholar
  3. 3.
    Hook EW. Syphilis. Lancet. 2017;389:1550–7.CrossRefGoogle Scholar
  4. 4.
    Hook EW. Syphilis. In: Goldman L, Schafer AI, editors. Goldman’s Cecil medicine. 24th ed. Toronto: Elsevier; 2011. p. 1922–9.Google Scholar
  5. 5.
    Byard RW. Syphilis – cardiovascular manifestations of the great imitator. J Forensic Sci. 2018;64:1312–5.CrossRefGoogle Scholar
  6. 6.
    Ghanem KG. Neurosyphilis: a historical perspective and review. CNS Neurosci Ther. 2010;16:e157–68.CrossRefPubMedGoogle Scholar
  7. 7.
    Sukthankar A. Syphilis. Medicine. 2014;42:394–8.CrossRefGoogle Scholar
  8. 8.
    Stamm LV. Syphilis: re-emergence of an old foe. Microb Cell. 2016;3:363–70.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    La Fond RE, Lukehart SA. Biological basis for syphilis. Clin Microbiol Rev. 2006;19:29–49.CrossRefGoogle Scholar
  10. 10.
    Tsokos M. Syphilitic aortic aneurysm rupture as cause of sudden death. Forensic Sci Med Pathol. 2012;8:325–6.CrossRefPubMedGoogle Scholar
  11. 11.
    Roberts WC, Barbin CM, Weissenborn MR, Ko JM, Henry AC. Syphilis as a cause of thoracic aortic aneurysm. Am J Cardiol. 2015;116:1298–303.CrossRefPubMedGoogle Scholar
  12. 12.
    Roberts WC, Ko JM, Vowels TJ. Natural history of syphilitic aortitis. Am J Cardiol. 2009;104:1578–87.CrossRefPubMedGoogle Scholar
  13. 13.
    Marra CM. Neurosyphilis. Continuum. 2015;21:1714–28.PubMedGoogle Scholar
  14. 14.
    Hassin GB. Tabes dorsalis. Arch Neurol Psychiatr. 1929;21:311–41.CrossRefGoogle Scholar
  15. 15.
    Stern R. A study of the histopathology of tabes dorsalis with special reference to Richter’s theory of its pathogenesis. Brain. 1929;52:295–316.CrossRefGoogle Scholar
  16. 16.
    Brown E, Gray F. Bacterial infections. In: Love S, Louis D, Ellison DW, editors. Greenfield’s Neuropathology. 8th ed. Boca Raton: CRC Press; 2008. p. 1431.Google Scholar
  17. 17.
    Park KH, Lee MS, Hong IK, et al. Bone involvement in secondary syphilis: a case report and systematic review of the literature. Sex Transm Dis. 2014;41:532–7.CrossRefPubMedGoogle Scholar
  18. 18.
    Kang SH, Park SW, Kwon KY, Hong WJ. A solitary skull lesion of syphilitic osteomyelitis. J Korean Neurosurg Soc. 2010;48:85–7.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Son C, Samples D, Brenner A, Floyd J. Osteolytic calvarial lesions as initial presentation of latent neurosyphilis. J Clin Neurosci. 2010;22:909–10.CrossRefGoogle Scholar
  20. 20.
    Newman L, Kamb M, Hawkes S, Gomez G, Say L, Seuc A, et al. Global estimates of syphilis in pregnancy and associated adverse outcomes: analysis of multinational antenatal surveillance data. PLoS Med. 2013;10:e1001396.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Nyatsanza F, Tipple C. Syphilis: presentations in general medicine. Clin Med. 2016;16:184–8.CrossRefGoogle Scholar
  22. 22.
    Forrest CE, Ward A. Clinical diagnosis of syphilis: a ten-year retrospective analysis in a south Australian urban sexual health clinic. Int J STD AIDS. 2016;27:1334–7.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.School of MedicineThe University of AdelaideAdelaideAustralia

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