A case of syphilitic proctitis

Abstract

A 22-year-old male was admitted to our hospital with dyschezia and hemotochezia. Barium enema and colonoscopy revealed protruding lesions 7 cm above the anal verge. Laboratory tests showed that a positive reaction in serologic tests for syphilis and immunohistochemical staining of a rectal biopsy specimen demonstrated treponema pallidum. The protruding rectal lesions disappeared after penicillin therapy. On the basis of these findings, a diagnosis of syphilitic proctitis was made. Syphilitic proctitis is an extragenital chancre. Typically, the chancre forms at the site of sexual contact, hence anorectal chancres result from rectal intercourse with an infected person. In Europe and America, a number of infectious enteric ailments have a very high prevalence among homosexual men. Syphilitic proctitis is known to be one of these diseases, which are referred to collectively as 'Gay Bowel Syndrome'. Only six cases have been reported in Japan so far.