Rectal cancer mimic: a rare case of syphilitic proctitis

BMJ Case Rep. 2020 Dec 18;13(12):e235522. doi: 10.1136/bcr-2020-235522.

Abstract

Syphilitic proctitis is a rare presentation of sexually transmitted infection that poses a diagnostic challenge as it mimics rectal cancer clinically, radiologically and endoscopically. We report a case of a 66-year-old male patient with a background of HIV infection presenting with obstructive bowel symptoms and initial diagnosis of rectal cancer on CT. Sigmoidoscopy and histopathology were non-diagnostic. A diagnosis of secondary syphilis was suspected after obtaining sexual history and diagnostic serology, avoiding planned surgical intervention.

Keywords: HIV / AIDS; infection (gastroenterology); radiology; syphilis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Bacterial Agents / administration & dosage
  • Diagnosis, Differential
  • HIV Infections* / complications
  • HIV Infections* / therapy
  • Humans
  • Intestinal Obstruction* / diagnosis
  • Intestinal Obstruction* / etiology
  • Male
  • Penicillins / administration & dosage*
  • Proctitis / diagnosis*
  • Proctitis / etiology
  • Proctitis / physiopathology
  • Proctitis / therapy
  • Rectal Neoplasms / diagnosis*
  • Rectum* / diagnostic imaging
  • Rectum* / microbiology
  • Rectum* / pathology
  • Sexually Transmitted Diseases / diagnosis
  • Sexually Transmitted Diseases / therapy
  • Sigmoidoscopy / methods
  • Syphilis / complications
  • Syphilis / diagnosis
  • Syphilis / therapy
  • Tomography, X-Ray Computed / methods
  • Treponema pallidum* / immunology
  • Treponema pallidum* / isolation & purification

Substances

  • Anti-Bacterial Agents
  • Penicillins

Supplementary concepts

  • Syphilis, secondary