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Published on: April 26, 2019
Syphilitic proctitis presenting as rectal bleeding
Abhijeet Sugriv Ghodke1, Amol Dahale2, Debabrata Banerjee3
1Medical Gastroenterology, Dr D Y Patil Medical College Hospital and Research Centre, Pune, Maharashtra, India.
BMJ Case Reports
|June 1, 2026
Summary
Syphilitic proctitis, a rare rectal infection by Treponema pallidum, often mimics other conditions. Early diagnosis and penicillin treatment are crucial for recovery and preventing spread.
Area of Science:
- Infectious Diseases
- Gastroenterology
Background:
- Syphilitic proctitis is an uncommon manifestation of Treponema pallidum infection.
- It frequently presents with non-specific symptoms, leading to underdiagnosis, especially without systemic signs.
Purpose of the Study:
- To highlight the importance of considering Treponema pallidum infection in patients presenting with unexplained rectal bleeding.
- To emphasize early diagnosis and treatment of syphilitic proctitis.
Main Methods:
- A case report of a male patient in his 30s with isolated rectal bleeding.
- Diagnostic methods included sigmoidoscopy, Venereal Disease Research Laboratory (VDRL) testing, and rectal ulcer histopathology.
Main Results:
- Sigmoidoscopy showed superficial ulcers, erythematous mucosa, and focal erosions.
- VDRL testing and histopathology confirmed syphilitic proctitis.
- The patient achieved complete symptom resolution after treatment with intramuscular benzathine penicillin.
Conclusions:
- Syphilitic proctitis should be considered in patients with unexplained rectal bleeding, particularly those with a history of unprotected sexual activity.
- Prompt recognition and antibiotic therapy are vital for preventing complications and transmission.
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