Luetic aortopathy: Revisited

We report a case of 38-year-old male, who presented with a large pulsatile swelling on the left side of the anterior chest wall of 4 months’ duration with a gradual increase in size. He gave history of sexual promiscuity in the form of unprotected sexual intercourse prior to his marriage in his early 20s. He also gave a history of ulceration on coronal sulcus of glans penis 20 years back with painless right inguinal mass. His blood serology was strongly positive for syphilis and hepatitis B surface antigen (HBsAg); however, serology for retroviral infection was negative. Computed tomography–angiography confirmed the pulsatile swelling as aneurysm of the arch of and ascending aorta. In view of the history, positive serology, and imaging studies, we concluded the aortic aneurysm to be of syphilitic origin. We report this case due to its extreme rarity in the present antibiotic era.