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Case Reports

Syphilitic Aortitis: An Uncommon Cause of Acquired Aortopulmonary Fistula

^a Department of Cardiology, St. John's Medical College Hospital, Bangalore, India
^b Department of Cardiothoracic Surgery, St. John's Medical College Hospital, Bangalore, India
^c Department of General Medicine, St. John's Medical College Hospital, Bangalore, India
^d Department of Vascular Surgery, St. John's Medical College Hospital, Bangalore, India

Accepted for publication March 6, 2009.

^_* Address for correspondence Dr Adhyapak, Department of Cardiology, St. John's Medical College Hospital, Sarjapura Rd, Bangalore, 560034, India (Email: srili2881967{at}yahoo.com).

Cardiovascular syphilis has become a medical curiosity with the advent of widespread use of penicillin for the treatment of early syphilis. We report a case of a 37-year-old man who presented with sudden onset breathlessness that worsened insidiously for 1 year. Diagnosis of syphilitic aortopulmonary fistula was confirmed by aortography, contrast computed tomography, and histopathology. The patient underwent successful surgical correction. A high level of suspicion and awareness is needed for the diagnosis of this now rare disease. This entity is only amenable to surgical correction, even as existing surgical techniques need constant improvisation and individualization to each patient.