Clin Endosc > Volume 54(4); 2021 > Article
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Taki, Maekita, and Kitano: A Rare Case of a White-Furred Ileocecal Valve

Quiz

A 33-year-old, homosexual, sexually active man presented to the hospital with anal pain and hematochezia for >1 month. He had no signs of diarrhea or fever and no significant medical or pharmacotherapeutic history. Laboratory blood examination revealed increased white blood cell count (10,080; reference, 3300–8600/µL), C-reactive protein level (11.0; reference, 0.00–0.14 mg/mL), squamous cell carcinoma antigen (7.2; reference, 0–1.5 ng/mL), and HBs antigen (1067; reference, <0.005 IU/mL). Serum carcinoembryonic antigen (2.8; reference, 0–5 ng/mL), carbohydrate antigen 19-9 (17.3; reference, ≤37 U/mL), and cytomegalovirus antigenemia assay (C7-HRP) were all within reference ranges. No abnormalities were observed in the blood or fecal cultures. Computed tomography showed wall thickening from the left anus to the rectum. Colonoscopy showed a white-furred ileocecal valve, edematous and rough-surfaced mucosa throughout the entire colon, and an irregular and deep rectal ulcer (Fig. 1). Biopsy specimens were collected from every part of the colon and the ileocecal region. What is the diagnosis of a white-furred ulcerative lesion in the colon?
 

NOTES

Conflicts of Interest: The authors have no potential conflicts of interest.
Funding
None

Fig. 1.
Colonoscopy examination. (A) Colonoscopy showed a white-furred ileocecal valve. (B) Edematous and rough-surfaced mucosa throughout the entire colon. (C) Irregular and deep rectal ulcer.
ce-2021-159f1.jpg
Fig. 2.
Histopathological and colonoscopy examinations. (A) Histopathological examination showed Treponema pallidum on immunostaining. (B, C) Colonoscopy showed that the ulcer showed a tendency to improve after an intravenous administration of ceftriaxone sodium hydrate at 1 g/day for 1 week.
ce-2021-159f2.jpg

REFERENCES

1. Chen SY, Gibson S, Katz MH, et al. Continuing increases in sexual risk behavior and sexually transmitted diseases among men who have sex with men: San Francisco, Calif, 1999-2001, USA. Am J Public Health 2002;92:1387-1388.
crossref pmid
2. Ghanem KG. Evaluation and management of syphilis in the HIV-infected patient. Curr Infect Dis Rep 2010;12:140-146.
crossref pmid
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