Aortitis Diagnosed by F–18–Fluorodeoxyglucose Positron Emission Tomography in a Patient with Syphilis and HIV Coinfection

Abstract

The most common manifestation of cardiovascular syphilis, a rare diagnosis since the introduction of penicillin, is aortitis of the ascending aorta. Since the majority of patients with uncomplicated aortitis are asymptomatic, early diagnosis is difficult. We report the case of an HIV-positive patient with asymptomatic syphilitic aortitis that was incidentally diagnosed with F-18-fluorodeoxyglucose (FDG) positron emission tomography (PET). We conclude that FDG-PET could become a promising new imaging technique for both diagnosis and follow-up of patients with syphilitic aortitis.

Transient aortitis documented by positron emission tomography in a case series of men and transgender women infected with syphilis

“…In 2005, Kosters et al reported a case of widespread lymphadenopathy and aortitis in a participant with early syphilis infection co-infected with HIV using PET scan imaging 8. Kosters et al suggested that early aortic involvement might occur more often than thought, which is supported by the findings in our study.…”

EANM/SNMMI Guideline for18F-FDG Use in Inflammation and Infection

“…• AIDS-associated opportunistic infections, associated tumors, and Castleman disease (72)(73)(74)(75)(76)(77)(78)(79)(80)(81)(82)(83).…”

Probable Syphilitic Aortitis Documented by Positron Emission Tomography

“…In secondary syphilis inflammation has been previously described in association with hepatitis, uveitis, meningitis, and two cases of aortitis. [2, 3] Aortitis, if left untreated, can result in aortic root dilation could result in aortic insufficiency.…”

“…Investigators recently reported an incident finding of widespread syphilitic lymphadenopathy in early syphilis by PET scan [3]. Other reports have suggested that PET scans may be promising techniques for both diagnosis and follow–up of patients with syphilitic aortitis [2-4].…”