SACULAR ANEURYSM OF THE AORTA - IS TERTIA RY SYPHILIS A CURRENT CONCERN

A 71 year old man with a sacular aneurysm reported a history of syphil is and was found to have positive serological tests for the disease. H e was free of atheroma and the aneurysm was therefore ascribed to tert iary syphilis. Following implantation of a prosthesis, the post-operat ive course was uneventful. One year later clinical and Duplex-scan fin digns were normal. Syphilitic aneurysms have become rare but are still seen occasionally: nine other cases have been reported over the last five years. Syphilis should be considered in patients with sacular ane urysms. The diagnosis rests on history-taking and serological testing, although both can be negative. Histological studies can disclose sugg estive features. Patients who have not been treated previously for syp hilis should be given penicillin. Surgical removal of the aneurysm is required to prevent compression of the lung and rupture of the aneurys m.