Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2021; 9(26): 7909-7916
Published online Sep 16, 2021. doi: 10.12998/wjcc.v9.i26.7909
Gastrointestinal bleeding caused by syphilis: A case report
Dong-Jie Sun, Hai-Tao Li, Zhou Ye, Bin-Bin Xu, Da-Zhou Li, Wen Wang
Dong-Jie Sun, Hai-Tao Li, Zhou Ye, Bin-Bin Xu, Da-Zhou Li, Wen Wang, Department of Digestive Diseases, 900th Hospital of Joint Logistics Support Force, Fuzhou 350025, Fujian Province, China
Dong-Jie Sun, Hai-Tao Li, Zhou Ye, Bin-Bin Xu, Da-Zhou Li, Wen Wang, Fuzhou General Clinical Medical College, Fujian Medical University, Fuzhou 350025, Fujian Province, China
Dong-Jie Sun, Hai-Tao Li, Zhou Ye, Bin-Bin Xu, Da-Zhou Li, Wen Wang, Oriental Hospital Affiliated, Xiamen University, Xiamen 350025, Fujian Province, China
Author contributions: Xu BB, Li HT and Ye Z evaluated and diagnosed the patient; Li DZ and Wang W evaluated pathology specimens and provided images; Sun DJ performed literature review, reviewed the case and wrote the manuscript; All authors have read and approved the final manuscript.
Supported by Science and Technology Innovation Joint Fund Project of Fujian Province, No. 2018Y9116.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflicting interests.
CARE Checklist (2016) statement: We have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wen Wang, PhD, Additional Professor, Chief Physician, Full Professor, Occupational Physician, Department of Digestive Diseases, 900th Hospital of Joint Logistics Support Force, No. 156 North Road of West No. 2 Ring, Fuzhou 350025, Fujian Province, China. wangwenfj@163.com
Received: April 26, 2021
Peer-review started: April 26, 2021
First decision: June 6, 2021
Revised: June 15, 2021
Accepted: July 15, 2021
Article in press: July 15, 2021
Published online: September 16, 2021
Processing time: 136 Days and 16.9 Hours
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.

Keywords: Treponema pallidum; Alimentary tract hemorrhage; Small intestinal ulcer; Gastrointestinal syphilis; Infectious diseases; Case report

Core Tip: Syphilis is considered a sexually transmitted disease, which can affect all systems of the body and cause multiple clinical signs and symptoms. We report a rare case of gastrointestinal hemorrhage caused by Treponema pallidum. The case occurred in an adult male patient. The patient has not only suffered from atrial fibrillation, heart valvular disease, chronic pancreatitis, etc. for more than 10 years, but has also undergone heart valve replacement surgery. In recent years, the patient experienced recurrent unexplained gastrointestinal bleeding. Finally, based on careful analysis, syphilis was identified as the cause of intestinal ulcers that eventually led to gastrointestinal bleeding. This case shows that syphilis is a systemic disease and that it is important to treat syphilis as a couple.