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01.12.2017 | Case report | Ausgabe 1/2017 Open Access

BMC Infectious Diseases 1/2017

A case report of CT-diagnosed renal infarct secondary to syphilitic aortitis

Zeitschrift:
BMC Infectious Diseases > Ausgabe 1/2017
Autoren:
Maaike Spaltenstein, Françoise Humbert, Diem-Lan Vu, Ilker Uçkay, Gregor John
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12879-017-2624-1) contains supplementary material, which is available to authorized users.

Abstract

Background

Even though reported cases of syphilis have been increasing, cases of tertiary syphilis remain extremely rare. The majority of our knowledge with regard to complications of syphilis such as aortitis was acquired before the advent of relatively modern technologies such as CT, MRI and PET. This case report presents a rare case of syphilitic aortitis associated with a renal infarct caused by a peripheral arterial embolism diagnosed by CT.

Case presentation

We present a young man with sudden abdominal pain and flank tenderness without fever. Blood tests showed acute kidney failure. Computed tomography showed a right renal infarct and a non-circular thickening of the descending thoracic aortic wall with intra-luminal thrombus. Serology confirmed the diagnosis of syphilis. Treatment with anticoagulant and penicillin resulted in a good outcome. Follow-up PET-MRI showed resolution of the thrombus with a metabolically inactive atheromatous plaque.

Conclusion

Technologies, such as CT, PET-CT and PET-MRI, that were not present during the pre-antibiotic era, can provide new insights into rare presentations of tertiary syphilis such as aortitis. These imaging modalities show promise for early radiological diagnosis of aortitis in syphilis and may be useful for determining the response to treatment in specific cases.
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