Sexually transmitted proctitides

Abstract

Patients with sexually transmitted proctitides are increasingly presenting to doctors' offices. This may be secondary to increasing numbers of individuals participating in anal receptive intercourse and a rise in the incidence of sexually transmitted diseases. Although the sexually transmitted proctitides represent a small proportion of the overall number of cases of new proctitis, in certain populations the incidence of these diseases as causative agents is quite high, especially among men who have sex with men. Common causative agents include Neisseria gonorrhoeae, Chlamydia trachomatis, Treponema pallidum, and herpes simplex. Diagnosis may often be made on clinical grounds alone, and treatment requires antibiotics or antivirals. The clinician must remember to keep these diseases in mind while formulating a differential for the cause of proctitis.

Keywords: Sexually transmitted proctitis; anal receptive intercourse; proctitides.

Figure 1

Thayer-Martin agar culture showing N. gonorrhoeae (Courtesy of Department of Pathology, Western Pennsylvania Hospital, Pittsburgh, PA.)

Figure 2

Computed tomography scan of patient with proctitis and both lymphogranuloma venereum and syphilis serology revealing (A) inguinal lymphadenopathy and (B) proctitis with perirectal adenopathy. (Courtesy of Charles O. Finne III, M.D., Minneapolis, MN.)

Figure 3

Photograph of anal margin in patient with perianal herpes. Notice the typical “dewdrops on rose petals” appearance. (Courtesy of Charles O. Finne III, M.D., Minneapolis, MN.)

Figure 4

The multinucleated giant cell of herpes (Courtesy of Department of Surgery, Western Pennsylvania Hospital, Pittsburgh, PA.)