Sculpting the Silent Intricacies: A Rare Triad of Syphilitic Aneurysms Unveiled

Abstract

This case report revolves around a 73-year-old male patient who initially sought medical attention due to left lower extremity weakness. Suspicions of a potential vascular etiology arose during the initial clinical examination, prompting further investigation. Unexpectedly, computed tomography (CT) imaging of the abdomen and pelvis revealed the presence of three giant aneurysms. Concurrently, positive syphilis titers were identified. The patient's presentation, marked by focal neurological deficits, unveiled the incidental discovery of a triad of aneurysms involving the distal abdominal aorta, right common iliac, and left common iliac. The neurological symptoms observed in the patient were attributed to the compression within the left common iliac artery, leading to compromised blood flow to the lower extremity. Alternatively, the neurological deficits could be linked to neurosyphilis or a combination of both factors. This case underscores the critical role of considering syphilis in patients presenting with neurological symptoms. The unique discovery of extensive aortic abnormalities through imaging studies, specifically CT angiography, emphasized the importance of such diagnostic tools in unraveling complex and potentially life-threatening vascular pathologies. Recognizing the diverse manifestations of syphilis in patients with vast neurological symptoms is crucial for timely diagnosis and multidisciplinary management. This case emphasizes the need to keep a high index of suspicion for syphilis in individuals who have widespread aortic anomalies together with neurological symptoms, to sum up. The triad of aneurysms discovered incidentally in this 73-year-old patient underscores the intricate interplay between vascular and neurological manifestations. The timely diagnosis and multidisciplinary management of both the neurological and vascular aspects of this unique presentation are essential for ensuring optimal patient outcomes.

Keywords: abdominal aneurysm; aortic aneurysm; cardiovascular aneurysm; intra-abdominal aneurysm; triple aneurysms.