Acute hemorrhagic rectal ulcer (AHRU) is a serious disease characterized by sudden onset, painless massive bleeding from a rectal ulcer. We report a case of AHRU that developed during treatment for mandibular actinomycosis.
The patient was a 79-year-old man. Osteomyelitis of the right side of the mandible developed after extraction of his right lower molar at a private dental clinic.
The swelling spread from the temporomandibular joint to temporal area. Incision drainage was performed and Actinomyces israelii was detected from pus.
Antibacterial treatment with benzylpenicillin was given to manage the right mandibular actinomycosis.
Indolent mass melena occurred 10 days after the antibacterial drug treatment. Lower gastrointestinal endoscopy revealed an ulcer in rectum with arterial bleeding. Surgical clipping was performed.
We diagnosed this case as AHRU caused by bedrest with the background of arteriosclerosis. Treatment with benzylpenicillin was continued for 2 weeks and followed by the administration of amoxicillin for 6 months.
