Abstract
Nowadays, it is very rare to find cases of “gumma” in the syphilitic aorta. We describe here a case of perforated aortic aneurysm with syphilitic lesions (“gumma”). The patient, a 44-year-old male school teacher, collapsed during the gymnastic lesson at his school, and was sent to our hospital, where he died three hours later. Postmortem examination revealed a ruptured aortic aneurysm. This saccular thoracic aortic aneurysm (10 × 10 × 8 cm) originated just above the diaphragm. Perforation of the aneurysm was also found. The postmortem blood revealed no positive Wassermann's reaction. Microscopically, a number of “miliary gummas” were found in the aortic wall, accompanied by obliterative endarteritis with narrowing of the vasa vasorum lumen and lympho-plasmacytic infiltration. Treponema pallidum was found by the Levaditi method.
