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Bleeding in fresh concrete occurs when water from the mix rises to the surface. This happens because the mix's solid components fail to retain all the water as they settle, leading to separation where water collects at the top. The severity of bleeding can be measured by assessing the total settlement or by noting the decrease in height per unit height of concrete.
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Tail Vein Transection Bleeding Model in Fully Anesthetized Hemophilia A Mice
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Rectal bleeding caused by a syphilitic inflammatory mass.

Joao Serigado1, Eugene Lewis2, Grace Kim2

  • 1Medicine, University of Miami School of Medicine, Miami, Florida, USA.

BMJ Case Reports
|January 31, 2019
PubMed
Summary

A syphilis infection caused a rectal mass and liver lesions in an HIV-positive man. Spirochaetes were identified in biopsies, confirming syphilis as the cause.

Keywords:
HIV/AIDSinfection (gastroenterology)syphilisulcer

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Area of Science:

  • Infectious Diseases
  • Gastroenterology
  • Hepatology

Background:

  • Syphilis, a sexually transmitted infection, can manifest with diverse clinical presentations.
  • Human Immunodeficiency Virus (HIV) infection can alter the course and presentation of other infections.
  • Anorectal masses require thorough investigation to rule out various etiologies.

Observation:

  • A 47-year-old male presented with constitutional symptoms and gastrointestinal bleeding.
  • Colonoscopy identified a unique ulcerated mass at the anorectal junction.
  • The patient was concurrently diagnosed with HIV, syphilis, and hepatic lesions.

Findings:

  • Cerebrospinal fluid Veneral Disease Research Laboratory (VDRL) test was positive.
  • Biopsies of hepatic lesions and the rectal mass revealed spirochaetes via immunostaining.
  • The clinical presentation was attributed to a syphilitic inflammatory mass.

Implications:

  • This case highlights the importance of considering syphilis in the differential diagnosis of anorectal masses, especially in HIV-positive individuals.
  • Co-infection with HIV may influence the presentation and severity of syphilitic disease.
  • Prompt diagnosis and treatment of syphilis are crucial to prevent severe complications affecting multiple organ systems.