A pox on the heart: five cases of cardiovascular syphilis

MJA • Volume 184 Number 5 • 6 Mar The Medical Journal of Australia ISSN: 0025729X 6 March 2006 184 5 241-243 ©The Medical Journal of Australia 2006 www.mja.com.au Lessons from Practice nd the clinically apparent manifestations of aortic , coronary ostial stenosis and aortic aneurysms are –15%. Although aortic regurgitation is rarely caused it occurs in 20%–30% of patients with syphilitic ronary o tial lesions may be seen in 20%–25% of syphilitic aortitis, but it is uncommon for such S. yphilis has become a rare disease, although peaks of syphilis notifications occurred in Australia in the mid 1970s to mid 1980s and again more recently. Clinicians need to be aware of the manifestations of syphilis, and to consider the diagnosis outside the groups considered at risk of this infection in the modern era, such as men who have unprotected sex with other men. The five patients in our series ranged in age from 40 to 77 years. Notably, all were born overseas, and none belonged to a group considered at high risk of syphilis in the contemporary Australian context. Serology was consistent with acquisition of infection in the distant past in four of the five patients. Among patients with untreated syphilis, aortitis occurs in up to 70%–80%, a regurgitation seen in 10% by syphilis, aortitis. Co patients with Clinical records