Sudden death due to rupture of an aortic syphilitic aneurysm.

A 26-year-old man who suddenly collapsed and died was found at autopsy to have a ruptured aortic aneurysm which had the classic "tree bark" appearance of tertiary syphilis. Tracking of blood into the pericardial sac had resulted in sudden death from cardiac tamponade. Serological results were consistent with syphilis and HIV was excluded. Sudden death in a young HIV-negative man from the effects of syphilis is exceedingly rare nowadays.