RECTAL SYPHILIS – A DIAGNOSTIC CHALLENGE IN THE ENDOSCOPY DEPARTMENT
Abstract:
Rectal syphilis is a rare disease and is often overlooked in the differential diagnosis of
proctitis or rectal ulcer. The diagnosis of these lesions is difficult, as their clinical presentation points
the physician to more common conditions such as cancer or inflammatory bowel disease and can
therefore be treated incorrectly.(1) Endoscopic examination is a key investigation in the evaluation of
these lesions that may direct the diagnosis to an infectious cause, especially in men who have sex with
the male group (MSM).(2,3) We present the case of a patient who came to the proctology clinic for
rectal bleeding, anal mucus discharge and anal pain. The colonoscopic appearance is proctitis and
ulceration with flattened stamped edges, directing the diagnosis to an infectious cause of this rectal
lesion, raising the suspicion of rectal syphilis. The diagnosis was confirmed by the VDRL test.
Histopathological examination ruled out rectal cancer.
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