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We report the case of a 28-year-old transgender woman with a past medical history of ulcerative colitis, HIV, and syphilis, initially misdiagnosed with ulcerative colitis. Sigmoidoscopy showed a rectal ulcer; histology and positive syphilis serologies confirmed syphilitic proctitis. This case highlights the need to consider infectious causes in atypical or treatment-resistant proctitis, emphasising the value of a thorough history and targeted testing.<\/jats:p>","DOI":"10.1177\/09564624251363480","type":"journal-article","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T13:40:33Z","timestamp":1753882833000},"page":"1048-1050","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Syphilitic proctitis mimicking ulcerative colitis in a person living with HIV"],"prefix":"10.1177","volume":"36","author":[{"given":"Islam","family":"Rajab","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, St Joseph University Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayman","family":"Khaled","sequence":"additional","affiliation":[{"name":"An-Najah National University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5023-1361","authenticated-orcid":false,"given":"Hammam","family":"Jallad","sequence":"additional","affiliation":[{"name":"An-Najah National University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Nouri","sequence":"additional","affiliation":[{"name":"An-Najah National University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Elagami","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, St Joseph University Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walid","family":"Baddoura","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, St Joseph University Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qutayba Z","family":"Ayaseh","sequence":"additional","affiliation":[{"name":"An-Najah National University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,30]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-011-1935-0"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01240-11"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e31826a523e"},{"issue":"3","key":"e_1_3_3_5_2","first-page":"327","article-title":"Syphilitic proctitis","volume":"29","author":"Yang JF","year":"2016","unstructured":"Yang JF, Peng L, Siddiqui AA, et al. 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