Analysis of own observations of visceral syphilis lethal outcomes

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Abstract

The epidemiological situation of the syphilis incidence in the modern world is characterized as a “hidden” epidemic, which manifests itself in latent and late forms of the disease. Despite the general trend towards a decrease in the incidence of syphilis, there are some specific features in many regions of Russia. Deaths from visceral syphilis are now rare. The article presents data on the epidemiology, nosological forms of visceral syphilis, and describes two lethal outcomes. In observations, late syphilis was characterized by damage to several organs (liver, lungs, heart, brain), but the leading clinical manifestations were neurosyphilis (syphilitic meningoencephalitis) and cardiovascular syphilis (syphilitic mesaortitis, interstitial myocarditis). Damage of the respiratory and digestive organs (stomach, liver) are rare forms of visceral syphilis. In the presented observations, gummas in the lungs and liver, which were not clinically diagnosed, were detected. In all cases, the diagnosis of visceral syphilis was established at autopsy on the basis of a characteristic morphological picture (detection of gummas) and positive results of the Wassermann reaction.

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About the authors

Aleksander P. Nadeev

Novosibirsk State Medical University

Author for correspondence.
Email: nadeevngma@mail.ru
ORCID iD: 0000-0001-9428-2835

M.D., D. Sci. (Med.), Prof., Head, Depart. of Pathological Anatomy

Russian Federation, Novosibirsk, Russia

Alexander B. Krivosheev

Novosibirsk State Medical University

Email: krivosheev-ab@narod.ru
ORCID iD: 0000-0002-4845-8753

M.D., D. Sci. (Med.), Prof., Depart. of Faculty Therapy

Russian Federation, Novosibirsk, Russia

Angelina E. Pakhomova

Novosibirsk State Medical University

Email: pakhomova@ockk.ru
ORCID iD: 0000-0001-7541-6391

Student, Internat. School “Medicine of the Future”

Russian Federation, Novosibirsk, Russia

Mikhail A. Travin

Novosibirsk State Medical University

Email: mtravin@mail.ru
ORCID iD: 0000-0001-6385-5784

M.D., Cand. Sci. (Med.), Assoc. Prof., Depart. of Pathological Anatomy

Russian Federation, Novosibirsk, Russia

Ekaterina E. Pakhomova

Novosibirsk State Medical University

Email: pakhomova@ockk.ru
ORCID iD: 0000-0001-9256-3094

Student, Institute of Clinical Medicine

Russian Federation, Novosibirsk, Russia

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Supplementary files

Supplementary Files
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1. Рис. 1. Гумма в лёгком: очаг казеозного некроза, окружённый валом из воспалительных клеток. Окраска гематоксилином и эозином. Увеличение ×50

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2. Рис. 2. Гумма в лёгком: вокруг очага казеозного некроза воспалительный инфильтрат из лимфоцитов, макрофагов, плазмоцитов, эндоартериит. Окраска гематоксилином и эозином. Увеличение ×200

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3. Рис. 3. Сифилитический мезаортит: разрушение эластических волокон в средней оболочке аорты. Окраска резорцин-фуксином Вейгерта. Увеличение ×100

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4. Рис. 4. Сифилитический мезаортит. Гуммозный инфильтрат в средней оболочке аорты: клеточный состав инфильтрата представлен плазмоцитами, макрофагами, лимфоцитами. Окраска гематоксилином и эозином. Увеличение ×400

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