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Ruptured Syphilitic Aneurysm: A Cause of Sudden Death in a Man with Human Immunodeficiency Coinfection.

Authors
  • Ro, Ayako1, 2
  • Mori, Shinjirou2
  • Kageyama, Norimasa1, 2
  • Chiba, Shoetsu1
  • Mukai, Toshiji1
  • 1 Department of Legal Medicine, St. Marianna University School of Medicine, Kanagawa, 216-8511, Japan. , (Japan)
  • 2 Tokyo Medical Examiner's Office, Otuska 4-21-18, Bunkyo-ku, Tokyo, 112-0012, Japan. , (Japan)
Type
Published Article
Journal
Journal of forensic sciences
Publication Date
Sep 01, 2019
Volume
64
Issue
5
Pages
1555–1558
Identifiers
DOI: 10.1111/1556-4029.14046
PMID: 30893469
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Syphilis, a sexually transmitted infection caused by the bacterium Treponema palladium, is experiencing a worldwide resurgence. The risk of syphilis infection is particularly high in men who have sex with men (MSM), especially those who are human immunodeficiency virus (HIV)-positive. Untreated syphilis can lead to rare but severe late-stage complications, including syphilitic aortitis. Herein, we present an autopsy case of a ruptured thoracic aneurysm that resulted from an undetected case of syphilitic aortitis in an HIV-positive Japanese MSM with undiagnosed syphilis. Although no syphilitic skin lesions were observed on the body, anatomical changes consistent with a syphilitic etiology were present at the site of the rupture, including medial aortic scarring with "tree-bark"-like atherosclerotic plaque. In addition, heart blood was positive for T. palladium in a latex agglutination test. This case highlights for forensic pathologists the importance of recognizing syphilis as a possible underlying cause of sudden death among HIV-positive MSM. © 2019 American Academy of Forensic Sciences.

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