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

Article Article scientifique Rapport de cas A case report of CT-diagnosed renal infarct secondary to syphilitic aortitis eng 2017 author Spaltenstein Maaike author Humbert Françoise 650324 author Vu Cantero Diem-Lan 527382 author Uckay Ilker 134868 author John Gregor Raphaël 0000-0002-1548-7339 510375 520 10.1186/s12879-017-2624-1 28747159 1471-2334 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. Dewey 610/370 Dewey 616 48 Unité de développement et de recherche en éducation médicale 204 56 Département de médecine 221 false BMC Infectious Diseases 17 1 fede10a7-cfef-4cb3-88d3-a3e534ac5b04 Article (Published version) Public Aortitis.pdf 848815 application/pdf openAccess Faculté de médecine / Unité de développement et de recherche en éducation médicale Faculté de médecine / Section de médecine clinique / Département de médecine

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A case report of CT-diagnosed renal infarct secondary to syphilitic aortitis	BMC Infectious Diseases			2017	507	230

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Humbert, Françoise