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Gastrointestinal bleeding caused by syphilis: A case report.

Dong-Jie Sun¹, Hai-Tao Li¹, Zhou Ye¹

¹Department of Digestive Diseases, 900 Hospital of Joint Logistics Support Force, Fuzhou 350025, Fujian Province, China.

World Journal of Clinical Cases

|October 8, 2021

Summary

Syphilis, a sexually transmitted infection, can rarely cause obscure gastrointestinal bleeding. Prompt diagnosis and treatment of Treponema pallidum infection resolved symptoms in a patient with obscure bleeding.

Keywords:

Alimentary tract hemorrhage Case report Gastrointestinal syphilis Infectious diseases Small intestinal ulcer Treponema pallidum

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Area of Science:

Gastroenterology
Infectious Diseases
Cardiology

Background:

Syphilis, caused by Treponema pallidum, is a systemic sexually transmitted infection.
While colorectal bleeding is documented, small intestinal bleeding due to syphilis is uncommon.
Syphilis can manifest with diverse symptoms affecting multiple organ systems.

Observation:

A 58-year-old male presented with chronic abdominal pain and melena.
Initial investigations including endoscopy and CT angiography were inconclusive for bleeding sources.
Capsule endoscopy revealed multiple intestinal ulcers, leading to a syphilis diagnosis.

Findings:

The patient had a history of atrial fibrillation, chronic pancreatitis, and valvular heart disease requiring surgery.
Anti-syphilis treatment led to the resolution of gastrointestinal bleeding and abdominal pain.
Syphilis was implicated as a potential cause for the patient's diverse medical conditions.

Implications:

This case highlights syphilis as a rare but significant cause of obscure gastrointestinal bleeding.
Early consideration of syphilis is crucial for diagnosing unexplained bleeding, even in the small intestine.
Effective syphilis management necessitates treating both sexual partners to prevent recurrence and transmission.