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Transient aortitis documented by positron emission tomography in a case series of men and transgender women infected with syphilis

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dc.contributor.author Joseph Davey, Dvora
dc.contributor.author Kojima, Noah
dc.contributor.author Konda, Kelika A.
dc.contributor.author Gupta, Pawan
dc.contributor.author Leon, Segundo R.
dc.contributor.author Calvo, Gino M.
dc.contributor.author Caceres, Carlos F.
dc.contributor.author Klausner, Jeffrey D.
dc.date.accessioned 2019-01-25T16:20:55Z
dc.date.available 2019-01-25T16:20:55Z
dc.date.issued 2017
dc.identifier.uri https://hdl.handle.net/20.500.12866/4784
dc.description.abstract OBJECTIVES: Syphilis infection persists globally contributing to preventable and treatable morbidity and mortality. How extensive early syphilis disseminates is unknown. To better understand the relationship between early syphilis infection and inflammation over time, our study enrolled six individuals recently infected with syphilis for sequential positron emission tomography (PET) scans. METHODS: We evaluated a case series of six individuals with high syphilis titres (two secondary, two early latent and two latent, unknown duration, but with high titre) who received sequential PET scans to assess inflammation over time and its response to treatment. RESULTS: At time of PET scan, four of the six individuals were co-infected with HIV. One of the four was not on antiretroviral therapy and three of the four were not virally suppressed (viral load of >400 copies/mL). Baseline rapid plasma reagin (RPR) titres ranged from 1:64 to 1:256 (four of the six participants had prior non-reactive RPR results). Five of the six participants had mild to intense hypermetabolic PET scan activity consistent with cervical (n=5), axillary (n=4), inguinal (n=5) and retroperitoneal (n=1) adenopathy. Mild hypermetabolic activity in the thoracic aortic wall, suggesting aortitis, was present among the same five participants and resolved within 30 days for four of the five participants and 60 days for the other participant. However, widespread lymphadenopathy remained present in PET scans up to 3 months following treatment in two participants. We did not find any abnormal PET scan activity of the central nervous system. CONCLUSION: We found abnormal aortic wall PET scan activity suggesting aortitis to be common in a case series of patients with early syphilis. In research settings, PET scans may be a sensitive tool to monitor inflammation associated with syphilis. en_US
dc.language.iso eng
dc.publisher BMJ Publishing Group
dc.relation.ispartof urn:issn:1472-3263
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Adult en_US
dc.subject Female en_US
dc.subject Humans en_US
dc.subject Male en_US
dc.subject Young Adult en_US
dc.subject Middle Aged en_US
dc.subject Referral and Consultation en_US
dc.subject Directive Counseling en_US
dc.subject Transgender Persons en_US
dc.subject Syphilis en_US
dc.subject HIV Infections/complications en_US
dc.subject Aortitis en_US
dc.subject Positron-Emission Tomography en_US
dc.subject Syphilis Cardiovascular en_US
dc.subject Aortitis/complications/diagnostic imaging/drug therapy/microbiology en_US
dc.subject Syphilis/complications en_US
dc.title Transient aortitis documented by positron emission tomography in a case series of men and transgender women infected with syphilis en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1136/sextrans-2017-053140
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.15

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