Korean J Gastroenterol.  2016 Oct;68(4):218-220. 10.4166/kjg.2016.68.4.218.

A Case of Rectal Syphilis Incidentally Found at Regular Medical Check-up

• You JH
• Cho KW
• Cha YJ
• Park HJ

• KMID: 2383519
• DOI: http://doi.org/10.4166/kjg.2016.68.4.218

Abstract

Syphilis is a rare disease in the rectum. It is difficult to diagnose because the characteristics of the rectal syphilis rectal lesion are highly varied. The endoscopic findings of rectal syphilis are proctitis, ulcers, and masses. If rectal syphilis is suspected to be the cause for rectal lesions, it is important for physicians to consider the sexual history and sexual orientation of the patient. We report a case of incidental rectal syphilis in a 41-year-old man diagnosed during a regular medical check-up.

Keyword

Rectum; Syphilis; Ulcer; Treponema pallidum

MeSH Terms

Adult
Humans
Proctitis
Rare Diseases
Rectum
Sexual Behavior
Syphilis*
Treponema pallidum
Ulcer

Figure

• 

  Fig. 1. Colonoscopic findings indicated several polypoid hyperemic lesions.

• 

  Fig. 2. Colonoscopic findings. (A) Multiple ulcers 5–6 cm from anal verge. (B) A close-up of the ulcer farthest from anal verge.

• 

  Fig. 3. Microscopic findings of a ulcer in the rectum. (A) The superficial ulceration associated with underlying dense inflammation rich in plasma cells (H&E, ×400). (B) Warthin-Starry stain (×400) reveals many spirochetes. Multiple spiral rods (arrows) are spirochetes.

Reference

References

1. Choi KC, Song JY. Recent trends in clinical observation of syphilis and consideration for laboratory tests. J Korean Med Assoc. 2009; 52:1100–1106.

2. Gopal P, Shah RB. Primary anal canal syphilis in men: The clinicopathologic spectrum of an easily overlooked diagnosis. Arch Pathol Lab Med. 2015; 139:1156–1160.

3. Korea Centers for Disease Control and Prevention. 2013 White book of disease control. Cheongju: Korea Centers for Disease Control and Prevention;2014.

4. Ghanem KG, Workowski KA. Management of adult syphilis. Clin Infect Dis. 2011; 53(Suppl 3):S110–S128.

5. Kim T. Treatment and management of sexually transmitted diseases. J Korean Med Assoc. 2008; 51:884–896.

6. Song SH, Jang I, Kim BS, et al. A case of primary syphilis in the rectum. J Korean Med Sci. 2005; 20:886–887.

7. Cha JM, Choi SI, Lee JI. Rectal syphilis mimicking rectal cancer. Yonsei Med J. 2010; 51:276–278.

8. Zhao WT, Liu J, Li YY. Syphilitic proctitis mimicking rectal cancer: A case report. World J Gastrointest Pathophysiol. 2010; 1:112–114.