Pop Anca Maria, Zimmermann Roman, Pekardi Szilveszter, Cipriani Michela, Gajur Angelika Izabela, Moser Diana, Markert Eva, Kueres-Wiese Alexander
Department of Internal Medicine, HOCH Health Ostschweiz, Wil Hospital, 9500 Wil, Switzerland.
Department of Gastroenterology and Hepatology, HOCH Health Ostschweiz, Wil Hospital, 9500 Wil, Switzerland.
J Clin Med. 2025 Jul 24;14(15):5254. doi: 10.3390/jcm14155254.
: Infectious proctitis remains an underrecognized entity, although sexually transmitted diseases, especially bacterial infections, exhibit a marked increase in their incidence. : Here, we report a case of a 44-year-old man who presented to the emergency department with lower abdominal and rectal pain, tenesmus, fever and night sweats for the past 6 days. : The computed tomography initially revealed a high suspicion of metastatic rectal cancer. The endoscopic findings showed a 5 cm rectal mass, suggestive of malignancy. The histologic examination showed, however, no signs of malignancy and lacked the classical features of an inflammatory bowel disease, so an infectious proctitis was further suspected. The patient reported to have had unprotected receptive anal intercourse, was tested positive for Treponema pallidum serology and received three doses of intramuscular benzathine penicillin G. A control rectosigmoidoscopy, imaging at 3 months and histological evaluation after antibiotic treatment showed a complete resolution of inflammation. : Syphilitic proctitis may mimic various conditions such as rectal cancer or inflammatory bowel disease and requires a high degree of suspicion. Clinicians need to be aware of infectious proctitis in high-risk populations, while an appropriate thorough medical history may guide the initial diagnostic steps.
感染性直肠炎仍然是一个未被充分认识的疾病，尽管性传播疾病，尤其是细菌感染的发病率显著上升。在此，我们报告一例44岁男性病例，该患者因过去6天出现下腹部和直肠疼痛、里急后重、发热和盗汗而就诊于急诊科。计算机断层扫描最初高度怀疑为转移性直肠癌。内镜检查发现直肠有一个5厘米的肿物，提示为恶性肿瘤。然而，组织学检查未显示恶性迹象，也缺乏炎症性肠病的典型特征，因此进一步怀疑为感染性直肠炎。患者报告有过无保护的被动肛交史，梅毒螺旋体血清学检测呈阳性，并接受了三剂肌内注射苄星青霉素G。抗生素治疗后的对照直肠乙状结肠镜检查、3个月时的影像学检查和组织学评估显示炎症完全消退。梅毒性直肠炎可能会模仿各种疾病，如直肠癌或炎症性肠病，需要高度怀疑。临床医生需要意识到高危人群中的感染性直肠炎，而适当详尽的病史可能会指导初步诊断步骤。
