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Sun DJ, Li HT, Ye Z, Xu BB, Li DZ, Wang W. Gastrointestinal bleeding caused by syphilis: A case report. World J Clin Cases 2021; 9:7909-7916. [PMID: 34621845 PMCID: PMC8462228 DOI: 10.12998/wjcc.v9.i26.7909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/15/2021] [Accepted: 07/15/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Syphilis is a chronic, classic sexually transmitted disease caused by Treponema pallidum, which can invade almost all organs of the body and produce various symptoms and signs. Although there are some cases of colorectal bleeding caused by syphilis, small intestinal bleeding caused by syphilis is still rare.
CASE SUMMARY A 58-year-old man had experienced recurrent abdominal pain and melena for 3 years. Repeated gastroenteroscopy and computed tomography angiography examinations failed to find bleeding lesions. During the same admission, multiple intestinal ulcers were found by capsule endoscopy, and syphilis was also diagnosed. With a history of atrial fibrillation and chronic pancreatitis, he had undergone mitral valve replacement and tricuspid valvuloplasty for valvular heart disease. After anti-syphilis treatment, the melena and abdominal pain disappeared and his hemoglobin gradually increased. It is considered that gastrointestinal bleeding, chronic pancreatitis, atrial fibrillation, and heart valvular disease may have been caused by syphilis.
CONCLUSION This case report found that syphilis can mimic systemic disease and cause intestinal bleeding. In addition, treatment of the disease requires both sexual partners to be treated. Finally, although syphilis is easy to treat, it is more important to consider that bleeding could be caused by syphilis.
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Affiliation(s)
- Dong-Jie Sun
- Department of Digestive Diseases, 900th Hospital of Joint Logistics Support Force, Fuzhou 350025, Fujian Province, China
- Fuzhou General Clinical Medical College, Fujian Medical University, Fuzhou 350025, Fujian Province, China
- Oriental Hospital Affiliated, Xiamen University, Xiamen 350025, Fujian Province, China
| | - Hai-Tao Li
- Department of Digestive Diseases, 900th Hospital of Joint Logistics Support Force, Fuzhou 350025, Fujian Province, China
- Fuzhou General Clinical Medical College, Fujian Medical University, Fuzhou 350025, Fujian Province, China
- Oriental Hospital Affiliated, Xiamen University, Xiamen 350025, Fujian Province, China
| | - Zhou Ye
- Department of Digestive Diseases, 900th Hospital of Joint Logistics Support Force, Fuzhou 350025, Fujian Province, China
- Fuzhou General Clinical Medical College, Fujian Medical University, Fuzhou 350025, Fujian Province, China
- Oriental Hospital Affiliated, Xiamen University, Xiamen 350025, Fujian Province, China
| | - Bin-Bin Xu
- Department of Digestive Diseases, 900th Hospital of Joint Logistics Support Force, Fuzhou 350025, Fujian Province, China
- Fuzhou General Clinical Medical College, Fujian Medical University, Fuzhou 350025, Fujian Province, China
- Oriental Hospital Affiliated, Xiamen University, Xiamen 350025, Fujian Province, China
| | - Da-Zhou Li
- Department of Digestive Diseases, 900th Hospital of Joint Logistics Support Force, Fuzhou 350025, Fujian Province, China
- Fuzhou General Clinical Medical College, Fujian Medical University, Fuzhou 350025, Fujian Province, China
- Oriental Hospital Affiliated, Xiamen University, Xiamen 350025, Fujian Province, China
| | - Wen Wang
- Department of Digestive Diseases, 900th Hospital of Joint Logistics Support Force, Fuzhou 350025, Fujian Province, China
- Fuzhou General Clinical Medical College, Fujian Medical University, Fuzhou 350025, Fujian Province, China
- Oriental Hospital Affiliated, Xiamen University, Xiamen 350025, Fujian Province, China
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Abstract
Researchers from the Division of Paleopathology of Pisa University (Pisa, Italy) exhumed the well-preserved skeleton of Maria Salviati (1499–1543), wife of Giovanni de’ Medici, named “Giovanni of the Black Bands,” in Florence in 2012. Many lytic lesions had affected the skull of Maria on the frontal bone and on the parietal bones. These lesions are pathognomonic for syphilis. An ancient diagnosis of syphilis for Maria Salviati does not emerge from the historical sources, although the symptoms manifested in her last years of life are compatible with a colorectal localization, including severe hemorrhages, caused by syphilitic infection. The case of Maria Salviati can be compared with those of other famous Italian noblewomen of the Renaissance, such as Isabella of Aragon (1470–1524) and Maria of Aragon (1503–1568). Paleopathology made it possible to directly observe a “secret illness” to which noblewomen were susceptible as a result of the sexual conduct of their husbands.
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Ayoade F, Gonzales Zamora JA, Tjendra Y. Herpes Simplex Virus Proctitis Masquerading as Rectal Cancer. Diseases 2019; 7:diseases7020036. [PMID: 31010103 PMCID: PMC6630232 DOI: 10.3390/diseases7020036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 04/20/2019] [Accepted: 04/21/2019] [Indexed: 12/02/2022] Open
Abstract
Herpes simplex virus (HSV) is the leading cause of proctitis in HIV-infected individuals. However, no cases of rectal masses secondary to HSV infection have been reported to date. Herein, we present the case of a 45-year-old man with HIV infection who developed rectal pain and bleeding, along with dysuria and voiding difficulty. Colonoscopy revealed proctitis and a rectal mass with features concerning for rectal cancer. Histologic sections of the rectal mass biopsy demonstrated colorectal mucosa with viral cytopathic changes, ulceration, granulation tissue, marked inflammatory infiltrate, and fibrinopurulent exudate. Immunohistochemistry for herpes simplex virus-1 was positive in epithelial cells demonstrating a viral cytopathic effect. The patient was treated with valacyclovir for 3 weeks, which led to complete resolution of his symptoms. Follow-up sigmoidoscopy at 6 months did not show any masses. Our case illustrates the importance of considering HSV in the differential diagnosis of rectal masses. We advocate the routine use of viral immunohistochemistry for the evaluation of rectal tumors, especially in patients with clinical manifestations and endoscopic findings consistent with proctitis.
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Affiliation(s)
- Folusakin Ayoade
- Division of Infectious Diseases. Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
| | - Jose Armando Gonzales Zamora
- Division of Infectious Diseases. Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
| | - Youley Tjendra
- Department of Pathology and Laboratory Medicine, Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
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