[Sexually transmitted infectious proctitis: diagnostic challenge and treatment recommendations]
Janeth Bejarano Rengifo1, Raúl Cañadas Garrido2
1Pontificia Universidad Javeriana. Bogotá, Colombia.
Abstract:
Sexually transmitted infectious proctitis is an inflammatory process of the rectum secondary to infection by sexually transmitted germs. Neisseria gonorrhoeae, Chlamydia trachomatis, Treponema pallidum, and herpes simplex virus (HSV) are the most frequently pathogens. Infectious proctitis is more prevalent in men who have sex with men (MSM) and in patients with human immunodeficiency virus (HIV) infection, however, it is also diagnosed in heterosexuals by changes in sexual behavior. Fecal urgency, purulent or bloody exudate, proctalgia, and tenesmus are the most common clinical manifestations. Detailed clinical history and a high index of suspicion are important to establish the diagnosis of this pathology; supported by endoscopic, histological, serological, and microbiological studies. Empirical treatment with antibiotics or antivirals is recommended, depending on clinical suspicion, and other sexually transmitted infections (STIs) should always be ruled out.
Insights
Sexually transmitted infectious proctitis, an inflammation of the rectum caused by STIs like gonorrhea and chlamydia, is common in men who have sex with men. Early diagnosis and treatment are crucial for managing this condition.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Public Health
Background:
- Sexually transmitted infectious proctitis is rectal inflammation caused by sexually transmitted germs.
- Common pathogens include Neisseria gonorrhoeae, Chlamydia trachomatis, Treponema pallidum, and herpes simplex virus (HSV).
- It disproportionately affects men who have sex with men (MSM) and individuals with HIV, but also occurs in heterosexuals.
Purpose of the Study:
- To review the epidemiology, clinical manifestations, diagnostic approaches, and management of sexually transmitted infectious proctitis.
Main Methods:
- Review of clinical history, endoscopic findings, histological examination, serological tests, and microbiological studies.
- Emphasis on clinical suspicion and ruling out other sexually transmitted infections (STIs).
Main Results:
- Key clinical symptoms include fecal urgency, purulent or bloody discharge, proctalgia, and tenesmus.
- Diagnosis relies on a combination of clinical evaluation and laboratory/endoscopic investigations.
- Empirical antibiotic or antiviral therapy is recommended based on clinical suspicion.
Conclusions:
- Prompt diagnosis and management of sexually transmitted infectious proctitis are essential.
- Comprehensive STI screening is critical in patients presenting with proctitis symptoms.
- Understanding risk factors and clinical presentations aids in effective patient care.
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