关键词: Treponema pallidum and rectitis chancre syphilis ulcer

Mesh : Adult Anti-Bacterial Agents / therapeutic use Cardiolipins Cholesterol Humans Magnetic Resonance Imaging Male Penicillin G Benzathine / therapeutic use Phosphatidylcholines Proctitis / diagnosis drug therapy Proctoscopy Syphilis / diagnosis drug therapy

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Abstract:
Rectal ulcerations are an uncommon presentation of a primary syphilis infection. Anorectal syphilis is difficult to diagnose because of its often asymptomatic or atypical clinical presentation. It is important to consider sexually transmitted diseases (STD) in all patients presenting with rectal symptoms. A history of anal sexual intercourse should be made, especially in men having sex with men (MSM). Moreover, the possibility of a primary syphilis infection of the rectum should be considered. Endoscopic findings might be diverse, whereas a typical chancre can present as an anorectal ulcer associated with regional lymphadenopathy. It is important to consider other causes of anorectal ulcers, like other STD, inflammatory bowel disease (IBD) or even malignant causes. The diagnosis of anorectal syphilis is based on the combination of the clinical presentation, serology tests, endoscopic findings and biopsies. The cornerstone of the treatment is based on an intramuscularly administration of a long-acting preparation of penicillin (benzathine penicillin G).
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