Diagnosis of syphilitic proctitis mimicking ulcerative colitis-A case report

摘要

Syphilis is a chronic bacterial infection caused by Treponema pallidum. Syphilitic lesions may coexist with other sexually transmitted diseases, and their endoscopic features often overlap with those of inflammatory bowel disease, other infection types, and nonsteroidal anti-inflammatory drug enteropathy. Thus, correctly diagnosing these lesions may be difficult, increasing the risk of inappropriate treatment. Here, we report a case of syphilitic proctitis that presented with diffuse rectal ulceration mimicking ulcerative colitis. A 24-year-old man presented with diffuse ulceration, observed during colonoscopy, in the region between his anus and rectum. The ulceration mimicked that associated with inflammatory bowel disease. The patient was successfully treated with intramuscular injections of benzylpenicillin (2.4 MU)/week for 3 weeks, resulting in improvements in proctitis. Syphilitic proctitis is rarely reported but is being recognized more frequently because of the increased incidence of syphilis among men who have sex with men. Therefore, clinicians should consider the possibility of syphilitic proctitis in high-risk patients.