{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T21:42:50Z","timestamp":1778103770008,"version":"3.51.4"},"reference-count":10,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,1,28]]},"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:p>Syphilis proctitis is a rare manifestation of syphilis, a bacterial sexually transmitted infection caused by <jats:italic>Treponema pallidum<\/jats:italic>. Syphilis proctitis can mimic other conditions including inflammatory bowel disease, lymphogranuloma venereum and anal or rectal cancer. We describe a case of a man in his 60s presenting with a variety of anorectal symptoms, where the definitive diagnosis was challenging, leading to diagnostic delay and a protracted symptom course due to difficulties in identifying and treating this rare manifestation of syphilis. After extensive investigations and various treatments, a diagnosis of syphilis was made, and treatment resulted in complete resolution of symptoms within 1\u2009month. This case highlights several issues for clinicians to consider during the diagnostic workup and management of patients presenting with anal symptoms and, in the context of a global upsurge in syphilis, serves as a reminder to remain vigilant to unusual and rare manifestations of infectious syphilis.<\/jats:p>","DOI":"10.1136\/bcr-2024-263948","type":"journal-article","created":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T02:07:28Z","timestamp":1742954848000},"page":"e263948","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Syphilis proctitis: an uncommon presentation of <i>Treponema pallidum<\/i> mimicking malignancy"],"prefix":"10.1136","volume":"18","author":[{"given":"Ian","family":"Hunter","sequence":"first","affiliation":[{"name":"BC Centre for Disease Control, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gang","family":"Wang","sequence":"additional","affiliation":[{"name":"BC Cancer - Vancouver, Vancouver, British Columbia, Canada"},{"name":"Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8039-6513","authenticated-orcid":false,"given":"Troy","family":"Grennan","sequence":"additional","affiliation":[{"name":"BC Centre for Disease Control, Vancouver, British Columbia, Canada"},{"name":"Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,3,25]]},"reference":[{"key":"2025082802275577000_18.3.e263948.1","unstructured":"Report on sexually transmitted infection surveillance in Canada, 2019. 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Available: https:\/\/www.canada.ca\/en\/public-health\/services\/publications\/diseases-conditions\/report-sexually-transmitted-infection-surveillance-canada-2019.html"},{"key":"2025082802275577000_18.3.e263948.2","doi-asserted-by":"crossref","first-page":"1550","DOI":"10.1016\/S0140-6736(16)32411-4","article-title":"Syphilis","volume":"389","author":"Hook","year":"2017","journal-title":"The Lancet"},{"key":"2025082802275577000_18.3.e263948.3","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e31826a523e"},{"key":"2025082802275577000_18.3.e263948.4","doi-asserted-by":"crossref","first-page":"S816","DOI":"10.14309\/01.ajg.0000780948.67983.ab","article-title":"S1854 Syphilitic Proctitis: A Rectal Cancer Mimic","volume":"116","author":"Kajal","year":"2021","journal-title":"Am J Gastroenterol"},{"key":"2025082802275577000_18.3.e263948.5","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1097\/MEG.0000000000001645","article-title":"Syphilitic proctitis imitating rectal malignancy","volume":"32","author":"Chiang","year":"2020","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"2025082802275577000_18.3.e263948.6","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1093\/infdis\/jiz616","article-title":"The Natural History of Anal Dysplasia: Unwrapping the Riddle to Find an Enigma","volume":"222","author":"Barroso","year":"2020","journal-title":"J Infect Dis"},{"key":"2025082802275577000_18.3.e263948.7","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.jdcr.2021.01.025","article-title":"Condyloma lata in secondary syphilis","volume":"10","author":"Pourang","year":"2021","journal-title":"JAAD Case Rep"},{"key":"2025082802275577000_18.3.e263948.8","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofab157","article-title":"Lower Gastrointestinal Syphilis: Case Series and Literature Review","volume":"8","author":"Ferzacca","year":"2021","journal-title":"Open Forum Infec Dis"},{"key":"2025082802275577000_18.3.e263948.9","doi-asserted-by":"crossref","first-page":"e68","DOI":"10.1097\/OLQ.0000000000000955","article-title":"A Case of Asymptomatic Syphilitic Proctitis","volume":"46","author":"Allan-Blitz","year":"2019","journal-title":"Sex Transm Dis"},{"key":"2025082802275577000_18.3.e263948.10","first-page":"327","article-title":"Syphilitic Proctitis","volume":"29","author":"Yang","year":"2016","journal-title":"Proc (Bayl Univ Med Cent)"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-263948","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:28:04Z","timestamp":1756373284000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-263948"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":10,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3,25]]},"published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1136\/bcr-2024-263948"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-263948","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3]]}}}