JACC. Case reports · 2025
Syphilitic Mitral Valve Endocarditis: Diagnostic Challenges and Clinical Management.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Bista Roshan, Zghouzi Mohamed, Odeleye Victoria, Eskind Caroline, Busler Forrest, Edwards Amber M, Rodriguez Evelio, Sager Andrew R, McMullan Paul W, Paul Timir K
Аннотация
BACKGROUND: Syphilis, caused by the bacterium Treponema pallidum, affects over 5 million people annually. Although rates have been declining, recent increases have been seen in men who have sex with men and in younger age groups.
CASE SUMMARY: A 38-year-old man with polysubstance abuse presented with chest pain, dyspnea, and orthopnea after a viral prodrome. Laboratory tests showed elevated levels of troponin and B-type natriuretic peptide. Coronary angiogram was normal, and right heart catheterization indicated elevated filling pressures. An echocardiogram showed severe mitral and tricuspid regurgitation, along with a 1.5 × 1.0 cm vegetation on the mitral valve. Syphilis serologies were positive, and polymerase chain reaction analysis of valve tissue confirmed the presence of T pallidum.
DISCUSSION: Untreated syphilis can progress to tertiary syphilis, causing syphilitic aortitis. Mitral valve endocarditis is rare. This case emphasizes the importance of considering syphilis in cases of culture-negative endocarditis.
TAKE-HOME MESSAGE: Consider T pallidum infection in cases of culture-negative endocarditis.
CASE SUMMARY: A 38-year-old man with polysubstance abuse presented with chest pain, dyspnea, and orthopnea after a viral prodrome. Laboratory tests showed elevated levels of troponin and B-type natriuretic peptide. Coronary angiogram was normal, and right heart catheterization indicated elevated filling pressures. An echocardiogram showed severe mitral and tricuspid regurgitation, along with a 1.5 × 1.0 cm vegetation on the mitral valve. Syphilis serologies were positive, and polymerase chain reaction analysis of valve tissue confirmed the presence of T pallidum.
DISCUSSION: Untreated syphilis can progress to tertiary syphilis, causing syphilitic aortitis. Mitral valve endocarditis is rare. This case emphasizes the importance of considering syphilis in cases of culture-negative endocarditis.
TAKE-HOME MESSAGE: Consider T pallidum infection in cases of culture-negative endocarditis.