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

• Ro, Ayako ^[1] ; Mori, Shinjirou ^[2] ; Kageyama, Norimasa ^[1] ; Chiba, Shoetsu ^[1] ; Mukai, Toshiji ^[1]
  1. [1] St. Marianna University School of Medicine

     St. Marianna University School of Medicine

     Kawasaki Ku, Japón

     
  2. [2] Tokyo Medical Examiner's Office, Otuska 4‐21‐18, Bunkyo‐ku, Tokyo, .Japan
• Localización: Journal of forensic sciences, ISSN-e 1556-4029, ISSN 0022-1198, Vol. 64, Nº. 5, 2019, págs. 1555-1558
• Idioma: inglés
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• Resumen

  • Syphilis, a sexually transmitted infection caused by the bacteriumTreponema palladium, is experiencing a worldwide resur-gence. The risk of syphilis infection is particularly high in men who have sex with men (MSM), especially those who are human immunodefi-ciency virus (HIV)-positive. Untreated syphilis can lead to rare but severe late-stage complications, including syphilitic aortitis. Herein, wepresent an autopsy case of a ruptured thoracic aneurysm that resulted from an undetected case of syphilitic aortitis in an HIV-positive JapaneseMSM with undiagnosed syphilis. Although no syphilitic skin lesions were observed on the body, anatomical changes consistent with a syphili-tic 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 forT. palladiumin a latex agglutination test. This case highlights for forensic pathologists the importance of recogniz-ing syphilis as a possible underlying cause of sudden death among HIV-positive MSM.