3.2 Differential diagnosis
Considered differential diagnosis include atherosclerotic and
syphilitic aneurysm and workup was only remarkable for a positive
syphilis screening test with reactive VDRL & RPR that was confirmed
with a positive TPHA, he tested negative for HIV. The patient was
diagnosed with tertiary cardiovascular syphilis and a decision was made
to treat the aneurysm surgically as soon as possible because its growth
could potentially rupture and risk the patient’s life.
Treatment and follow up
He was surgically managed with aneurysmorraphy and thrombus
evacuation, the aneurysmal section was resected and replaced with Dacron
graft. The first dose of 2.4 million/unit IM Penicillin-G was given to
be continued for 3 doses. He had a smooth postoperative condition and
was doing well on 6 months post operative follow-up
Discussion