2024 Volume 33 Issue 4 Pages 213-217
Syphilis has been on the rise in recent years, but syphilitic aortic aneurysm remains a rare disease. In this report, we describe a case of syphilitic thoracic aortic aneurysm treated with antimicrobial agents followed by surgical treatment. The patient is a 76-year-old woman. A brachiocephalic aneurysm and left common carotid artery origin stenosis were treated at another hospital 28 years ago with brachiocephalic aneurysm resection, resection opening patch closure, and aorta-left common carotid artery bypass surgery. She was positive for syphilis in the preoperative examination at that time, but was not routinely tested for syphilis after the surgery. This time, she was admitted to the department of internal medicine for congestive heart failure due to aortic valve regurgitation. The patient was positive for syphilis serology, and CT scan showed an ascending arch aortic aneurysm with a maximum short diameter of 57 mm, which was judged to be a probable syphilitic thoracic aortic aneurysm. There was no significant stenosis in the coronary arteries, but the left common carotid artery was occluded. The patient was treated for heart failure and received amoxicillin 1500 mg/day for 6 weeks, followed by ascending arch aortic prosthesis and aortic valve replacement.
