Syphilitic Proctitis with Early Syphilitic Hepatitis, Report of a Case Kentaro Kishi 1 , Shigeyuki Tamura 1 , Sumio Mizunoya 1 , Tadashi Kaneko 1 , Ken-ichi Yamashita 2 1Department of Surgery, Kinki Central Hospital 2Department of Pathology, Kinki Central Hospital Keyword: 梅毒性直腸炎 , 早期梅毒性肝炎 pp.110-114
Published Date 2001/1/25
DOI https://doi.org/10.11477/mf.1403103142
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 A 59-year-old male was admitted to our hospital complaining of anal pain. A hard uneven mass was felt in the 3 o'clock position on digital examination. Laboratory tests showed slightly elevated serum transamilase, bilirubin and a high level of alcaline phosphatase. A positive serological test result for syphilis was noted. Colonoscopy revealed an irregular-shaped ulcerative lesion just above the dental line, which was especially suggestive of rectal cancer. However, in spite of repeated microscopic examinations of endoscopic biopsy specimens taken from the ulcer edge, inflammatory infiltration consisting primarily of plasma cell was revealed, but no malignant cells were comfirmed. After penicillin therapy, the rectal lesion disappeard and results of liver function tests normalized completely and serological findings of syphilis revealed remarkable improvement. Although no Treponema pallidum was shown on microscopic examination, the diagnosis of syphilitic proctitis in this case was convincing because of the evidence above mentioned. Syphilitic proctitis with early syphilitic hepatitis has been thought to be rare. Only two cases have been reported in Japan so far.

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