title: [Syphilis proctitis complicated with HIV infection: a case report].
abstract: We report on a 26-year-old Japanese man who was referred to our hospital because of anal pain and hematochezia. On admission, in addition to his gastrointestinal symptoms, a generalized maculopapular rash was observed, involving the palms of his hands and soles of his feet. His history and physical examination were compatible with syphilis, confirmed by a high syphilis titer on blood examination. Further tests revealed the presence of HIV infection, with a CD4 cell count of 227/microL. Colonoscopy demonstrated a deep ulcer in the lower rectum, although biopsy specimens did not reveal any syphilis spirochetes, or any other specific microorganisms. Intravenous penicillin G was initiated, resulting in a dramatic improvement of the ulcers along with the skin lesions confirming the diagnosis of syphilis proctitis. A rapid plasma reagin titer test performed 3 months after treatment demonstrated significant decrease, indicating successful treatment.
authors.affiliation: Department of Infectious Diseases, Tokyo Metropolitan Komagome Hospital.
authors.forename: Ken-ichiro
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Naoki
authors.initials: N
authors.lastname: Yanagisawa
authors.forename: Akihiko
authors.initials: A
authors.lastname: Suganuma
authors.forename: Akifumi
authors.initials: A
authors.lastname: Imamura
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ajisawa
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D060085:Coinfection / Q000188:drug therapy*; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D010400:Penicillin G / Q000627:therapeutic use*; D011349:Proctitis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D013587:Syphilis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D016896:Treatment Outcome; D014210:Treponema pallidum / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents; D010400:Penicillin G