Quinn T C, Lukehart S A, Goodell S, Mkrtichian E, Schuffler M D, Holmes K K
Gastroenterology. 1982 Jan;82(1):135-9.
A 37-yr-old homosexual man presented with mild anorectal symptoms, a diffuse maculopapular rash, constitutional symptoms, and a reactive serologic test for syphilis. Sigmoidoscopy revealed a 2 x 2-cm indurated rectal mass 5 cm above the anal verge. Darkfield examination of rectal exudate revealed motile treponemes and rectal biopsy of the mass showed diffuse infiltration of plasma cells and lymphocytes. Large numbers of spirochetes were present on silver stain of the rectal biopsy specimen and these were shown to be Treponema pallidum by indirect immunofluorescence. The rectal mass and symptoms resolved following penicillin therapy. This case and a review of previously reported cases of anorectal syphilis emphasize the significance of these often neglected and misdiagnosed lesions of syphilis.
一名37岁的同性恋男性出现轻度肛肠症状、弥漫性斑丘疹皮疹、全身症状以及梅毒血清学反应阳性。乙状结肠镜检查发现距肛门边缘5厘米处有一个2×2厘米的硬结性直肠肿物。直肠渗出物暗视野检查发现活动的密螺旋体，肿物的直肠活检显示浆细胞和淋巴细胞弥漫浸润。直肠活检标本银染色显示大量螺旋体，间接免疫荧光显示这些螺旋体为梅毒螺旋体。青霉素治疗后，直肠肿物及症状消失。该病例以及对先前报道的肛肠梅毒病例的回顾强调了这些常被忽视和误诊的梅毒病变的重要性。
