{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T18:07:00Z","timestamp":1790359620331,"version":"4.1.0"},"reference-count":14,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"content-version":"vor","delay-in-days":362,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Medicine"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cardiovascular syphilis (CVS) is a rare but severe manifestation of tertiary syphilis, often remaining clinically silent until life\u2010threatening complications develop. Syphilitic aortitis can lead to aneurysmal degeneration, most commonly involving the ascending aorta and aortic arch. Despite advances in public health, the global resurgence of syphilis has renewed concern about its cardiovascular sequelae and the need for diagnostic vigilance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Report<\/jats:title>\n                    <jats:p>We describe a 59\u2010year\u2010old male with systemic hypertension and a remote smoking history, who was largely asymptomatic except for mild exertional dyspnea (New York Heart Association Class II). During routine preoperative evaluation for noncardiac surgery, imaging revealed a giant aortic arch aneurysm measuring 114\u2009\u00d7\u200994\u2009\u00d7\u200993\u2009mm, with associated dilatation of the ascending and descending aorta. Serologic testing confirmed syphilitic infection, and syphilitic aortitis was identified as the underlying etiology. After the completion of benzathine penicillin therapy, the patient underwent successful replacement of the ascending aorta and entire aortic arch under deep hypothermic circulatory arrest with selective antegrade cerebral perfusion. The supraaortic trunks were reimplanted en bloc using the island technique. Postoperative recovery was complicated by pleural effusion and transient neurological symptoms, both of which were managed conservatively, with full resolution. At two\u2010month follow\u2010up, the patient had returned to normal daily activities with preserved functional capacity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case illustrates an atypical, arch\u2010predominant presentation of CVS diagnosed incidentally in the contemporary era. It emphasizes the need to consider infectious etiologies, particularly syphilis, in patients with nonatherosclerotic or unusual aortic aneurysm patterns. Early recognition, appropriate antimicrobial therapy, and timely surgical intervention are essential to prevent catastrophic outcomes. The ongoing resurgence of syphilis underscores the importance of maintaining clinical awareness of this \u201cforgotten disease,\u201d especially in patients with atypical aortic pathology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/carm\/1281603","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T09:07:48Z","timestamp":1766999268000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Silent Threat: Incidental Diagnosis and Surgical Management of a Giant Syphilitic Aortic Aneurysm"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2412-529X","authenticated-orcid":false,"given":"Henrique Madureira Da Rocha","family":"Coutinho","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2731-861X","authenticated-orcid":false,"given":"Jos\u00e9 Xavier","family":"L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3089-6575","authenticated-orcid":false,"given":"Juan Luis","family":"Mu\u00f1oz Noblecilla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3230-7683","authenticated-orcid":false,"given":"Esmeralci","family":"Ferreira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaquim Henrique De Souza","family":"Aguiar Coutinho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,29]]},"reference":[{"key":"e_1_2_12_1_2","first-page":"1","article-title":"Syphilis Diagnosis, Treatment and Control: a Literature Review","volume":"10","author":"Cavalcanti J. R. P. B.","year":"2024","journal-title":"Review Ci\u00eanc Sa\u00fade"},{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.32552\/2023.actamedica.968"},{"key":"e_1_2_12_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/CRD.0000000000000863"},{"key":"e_1_2_12_4_2","first-page":"413","article-title":"Dysphonia and Odynophagia: a Late Presentation of Syphilis","volume":"61","author":"Barreto J.","year":"2023","journal-title":"Review Port Otorrinolaringology Cir Cabe\u00e7a Pesco\u00e7o"},{"key":"e_1_2_12_5_2","article-title":"Aortic Aneurysm and Severe Valvular Insufficiency due to Tertiary Syphilis in a Young Patient","volume":"10","author":"Velasco-Castro J. C.","year":"2023","journal-title":"Anales de la Facultad de Medicina"},{"key":"e_1_2_12_6_2","doi-asserted-by":"publisher","DOI":"10.5761\/atcs.cr.22-00236"},{"key":"e_1_2_12_7_2","doi-asserted-by":"publisher","DOI":"10.1080\/08998280.2022.2104528"},{"key":"e_1_2_12_8_2","doi-asserted-by":"publisher","DOI":"10.21037\/acr-22-32"},{"key":"e_1_2_12_9_2","doi-asserted-by":"publisher","DOI":"10.34119\/bjhrv6n1-254"},{"key":"e_1_2_12_10_2","doi-asserted-by":"publisher","DOI":"10.1590\/1677-5449.210160"},{"key":"e_1_2_12_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.carpath.2019.107175"},{"key":"e_1_2_12_12_2","doi-asserted-by":"publisher","DOI":"10.12659\/AJCR.941070"},{"key":"e_1_2_12_13_2","unstructured":"TavaresD. M. SaraivaJ. C. andCoutinhoG. F. Perioperative and long-term Results of Ascending Aorta Replacement: 432 Case Series. Faculdade De Medicina Da Universidade De Coimbra 2021."},{"key":"e_1_2_12_14_2","unstructured":"IsselbacherE. M. PreventzaQ. Hamilton BlackJ.et al. Peer Review Committee Members. 2022 ACC\/AHA Guideline for the Diagnosis and Management of Aortic Disease: A Report of the American Heart Association\/American College of Cardiology Joint Committee on Clinical Practice Guidelines Circulation146 2022 24 e334\u2013e482."}],"container-title":["Case Reports in Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/carm\/1281603","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/carm\/1281603","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/carm\/1281603","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T17:57:13Z","timestamp":1773770233000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/carm\/1281603"}},"subtitle":[],"editor":[{"given":"Poulami","family":"Jha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1155\/carm\/1281603"],"URL":"https:\/\/doi.org\/10.1155\/carm\/1281603","archive":["Portico"],"relation":{},"ISSN":["1687-9627","1687-9635"],"issn-type":[{"value":"1687-9627","type":"print"},{"value":"1687-9635","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2025-05-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"1281603"}}