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Case Reports
. 2019 Jan 28;12(1):e226595.
doi: 10.1136/bcr-2018-226595.

Rectal bleeding caused by a syphilitic inflammatory mass

Joao Serigado  1 , Eugene Lewis  2 , Grace Kim  2
Affiliations
Case Reports

Rectal bleeding caused by a syphilitic inflammatory mass

Joao Serigado et al. BMJ Case Rep. .

Abstract

A 47-year-old man presented with fatigue, decrease appetite, abdominal pain and rectal bleeding. His colonoscopy revealed a single, firm, raised, centrally ulcerated mass at the anorectal junction. During this same admission, he was diagnosed with HIV and syphilis, found to have multiple hepatic lesions and positive cerebrospinal fluidvenereal disease research laboratory test (VDRL). Biopsies from both the hepatic lesions and rectal ulcer showed spirochaetes by immunostaining. The initial presentation was felt to be secondary to a rectal inflammatory mass caused by syphilis.

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

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
An abdominal CT scan showing hepatic lesions (arrow 1), splenomegaly and rectal wall thickening (arrow 2).
Figure 2
Figure 2
A colonoscopy with direct visualisation of the rectum demonstrating ulcerated mass.
Figure 3
Figure 3
Biopsy of liver mass (H&E).
Figure 4
Figure 4
Biopsy of rectal mass (H&E).
Figure 5
Figure 5
A rectal mass biopsy demonstrating spirochaetes by immunostaining (demonstrated by arrows).
See this image and copyright information in PMC

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