Abbreviations
AAA- Abdominal aortic aneurysm
CDC- Center for disease control and prevention
RPR- Rapid plasma reagin
TPHA- Treponema pallidum hemagglutination assay
VDRL- Venereal disease research laboratory
Introduction
With the widespread use of antibiotics prevalence of late manifestations
of syphilis has become rare, uncomplicated syphilitic aortitis can occur
in 70-80% of untreated cases with complications including aortic
regurgitation, coronary ostial stenosis and aortic aneurysms occurring
in 10%, aneurysms may form over 15-30 years [1,2]. Serological
testing is useful in diagnosis and untreated it can lead to serious
complications [3].
The ascending aorta and transverse aortic arch are the two areas most
commonly affected which might be due to the rich lymphatic networks in
these segments. Treatment includes early antibiotic therapy and surgery
[4]. There aren’t many reports of syphilitic aneurysm in Africa and
in Ethiopia.
Case Presentation
History
A 50-year-old male presented with bilateral flank pain of 4
months duration, which was dull aching and radiates to the rest of the
abdomen. He also had loss of appetite, intermittent vomiting and easy
fatigability. He was a smoker 12.5 pack year for more than 25
years and chewed khat on a daily basis but stopped 7 months prior to his
presentation. He drank locally made alcohol (2-3 cups of Tela)
occasionally during weekends. He had no history of sexually
transmitted diseases and stated he practiced safe intercourse.
Examination
His vital signs are stable except for hypertension BP=145/98 .There were no pertinent findings on cardiovascular system . His
abdomen was flat, soft, moved with respiration and diffuse tenderness all over the abdomen was noted butno organomegaly, sign of fluid collection or pulsatile mass. He
also had no physical signs suggestive of Marfan syndrome or other
connective tissue disorders.
Methods