Anorectal herpes: radiographic findings

Area of Science:

• Gastroenterology
• Infectious Diseases
• Colorectal Surgery

Background:

• Herpes simplex virus (HSV) infections are typically associated with oral or genital lesions.
• Rectal and colonic manifestations of HSV are less commonly recognized.
• Differential diagnosis of ulcerative proctitis and colitis includes infectious and inflammatory etiologies.

Observation:

• Radiographic imaging demonstrated distinct ulcerations in the rectum and sigmoid colon.
• Lesions observed included aphthous ulcers, plaquelike erosions, and deep collar button ulcerations.
• The clinical presentation mimicked other forms of colitis or inflammatory bowel disease.

Findings:

• The findings suggest that HSV can manifest as significant ulcerative disease in the lower gastrointestinal tract.
• The characteristic ulcer morphologies (aphthous, collar button) are key diagnostic indicators.
• This case highlights the importance of considering viral etiologies in unexplained colorectal ulcerations.

Implications:

• Herpes simplex virus should be considered in the differential diagnosis of aphthous and collar button ulcerations of the rectum and colon.
• Recognition of these radiographic findings can lead to earlier diagnosis and appropriate antiviral treatment.
• Further research may elucidate the prevalence and pathogenic mechanisms of HSV in the gastrointestinal tract.