Disseminated CMV in immunocompetent patient post-first anal intimacy: A captivating case report

Cytomegalovirus (CMV) infections are uncommon in immunocompetent individuals, often posing diagnostic challenges due to their clinical overlap with other gastrointestinal disorders and sexually transmitted infections (STIs). Here, we report a case of a 37-year-old Immunocompetent Caucasian male who presented with rectal pain, bleeding, and fever following a recent sexual encounter. Initially treated for rectal gonorrhea, his symptoms persisted and worsened, prompting further investigation. Diagnostic evaluation revealed elevated liver enzymes, positive CMV IgM, and characteristic mucosal changes on sigmoidoscopy. Histopathological examination and CMV DNA testing confirmed the diagnosis of CMV proctitis. Treatment with intravenous ganciclovir led to clinical improvement and resolution of symptoms. This case underscores the importance of considering CMV infection in Immunocompetent patients with refractory rectal symptoms post-STI treatment, highlighting the need for thorough diagnostic assessment and timely initiation of antiviral therapy for effective management.