[Chlamydial proctitis in homosexual men]

We present 3 homosexual male patients, with lesions confined to the rectum, produced by chlamydia trachomatis. In the 3 patients the lesions were confined to the first 10 cm from of the anal margin, they were nodular, ulcerated and with stenotic tendency, difficult to differentiate macroscopically from a neoplasm. Multiple biopsy specimens from all patients reported chronic unspecific proctitis. In the 3 patients the presence of chlamydia trachomatis was confirmed by staining with lugol and giemsa from samples obtained by rectal smear, two of them presented simultaneous infection by neisseria gonorrhoeae, all were positive for HBsAg and one for HIV. Symptoms were tenesmus rectal urge, pain, thin feces and mucosanguinolent discharge. Treatment with 100 mg. Doxycycline BID for 21 days resulted in total remission in two patients; one patient with significant clinical improvement needed rectal bougienage.