2019 Volume 61 Issue 11 Pages 2491-2497
A homosexual man in his twenties visited a local doctor with complaints of tenesmus and bloody stools. He was referred to our hospital for detailed examination of rectal protruding lesions. Colonoscopy revealed three vertical ulcerative lesions in the anterior wall of the rectum. Two oral-side lesions accompanied the elevated lesions with ulcer. The endoscopic findings were similar to those of amebic colitis. Laboratory evaluation revealed positivity for the Treponema pallidum antibody and human immunodeficiency virus (HIV) and negativity for entamoeba histolytica antibody. Histological examination of rectal mucosa did not reveal amoeba. Immunostaining of rectal biopsy specimens with anti Treponema pallidum antibodies identified spirochetes. We diagnosed the patient with syphilitic proctitis complicated with HIV infection. The patient developed a skin eruption. Oral administration of amoxicillin was initiated. His digestive symptom and skin eruption resolved, and the rapid plasma reagin titers decreased.
