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International Journal of Colorectal Disease

, Volume 34, Issue 2, pp 359–362 | Cite as

Infectious proctitis: a necessary differential diagnosis in ulcerative colitis

  • Ana L. SantosEmail author
  • Rosa Coelho
  • Marco Silva
  • Elisabete Rios
  • Guilherme Macedo
Case Report
  • 160 Downloads

Abstract

Introduction

In the last years, there was a rising in the incidence of sexually transmitted infections, including proctitis. Infectious proctitis (IP), mainly caused by agents like Neisseria gonorrhea and Chlamydia trachomatis, is an entity that should be considered when patients with suspected inflammatory bowel disease (IBD) are approached, mainly if they have risk factors such as anal intercourse.

Clinical cases/Discussion

The symptoms of IP, like rectal blood, mucous discharge, and anorectal pain, may appear in other causes of proctitis, like IBD. Therefore, to establish the diagnosis, it is crucial to take a detailed history and perform a physical examination, with the diagnosis being supported by complementary tests such as rectosigmoidoscopy, histology, serology, and culture. Depending on the etiology, treatment of IP is based in antibiotics or antivirals, which may be empirically initiated. Co-infections, mainly those that are sexually transmitted, and HIV should be tested and sexual partners should be treated, accordingly. In this article, the authors report three cases of IP, referent to three different patients, and review the initial approach required in cases where there is a clinical and/or endoscopic suspicion of this pathology.

Keywords

Sexually transmitted infections Clinical history Rectal inflammation 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Hamlyn E, Taylor C (2006) Sexually transmitted proctitis. Postgrad Med J 82:733–736CrossRefGoogle Scholar
  2. 2.
    Workowski KA, Bolan GA (2015) Centers for disease control and prevention. MWR Recomm Rep 64:1–137CrossRefGoogle Scholar
  3. 3.
    Hoentjen F, Rubin T (2012) Infectious proctitis: when to suspect it is not inflammatory bowel disease. Dig Dis Sci 57:269–273CrossRefGoogle Scholar
  4. 4.
    Lamb C et al (2013) Sexually transmitted infections manifesting as proctitis. Front Gastroenterol 4:32–40CrossRefGoogle Scholar
  5. 5.
    El-Dhuwaib Y, Ammori BJ (2003) Perianal abscess due to Neisseria gonorrhoeae: an unusual case in the post-antibiotic era. Eur J Clin Microbiol Infect Dis 22:422–423CrossRefGoogle Scholar
  6. 6.
    Lee KJ, Kim J, Shin DH, Jung JO, Koh S, Kim KY, Lee JM (2015) Chlamydial proctitis in a young man who has sex with men: misdiagnosed as inflammatory bowel disease. Chonnam Med J 51(3):139–141CrossRefGoogle Scholar
  7. 7.
    White JA (2009) Manifestations and management of lymphogranuloma venereum. Curr Opin Infect Dis 22:57–66CrossRefGoogle Scholar
  8. 8.
    de Vries HJC, Morré SA, White JA, Moi H (2010) European guideline for the management of lymphogranuloma venereum. Int J STD AIDS 21:533–536CrossRefGoogle Scholar
  9. 9.
    McLean CA et al (2007) Treatment of lymphogranuloma venereum. Clin Infect Dis 44:147–152CrossRefGoogle Scholar
  10. 10.
    Gallegos M, Bradly D, Jakate S, Keshavarzian A (2012) Lymphogranuloma venereum proctosigmoiditis is a mimicker of inflammatory bowel disease. World J Gastroenterol 18:3317–3321Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Ana L. Santos
    • 1
    • 2
    • 3
    Email author
  • Rosa Coelho
    • 1
    • 2
    • 3
  • Marco Silva
    • 1
    • 2
    • 3
  • Elisabete Rios
    • 1
    • 2
    • 3
    • 4
  • Guilherme Macedo
    • 1
    • 2
    • 3
  1. 1.Gastroenterology DepartmentCentro Hospitalar de São JoãoPortoPortugal
  2. 2.WGO Oporto Training Center, Porto Medical SchoolUniversity of PortoPortoPortugal
  3. 3.Pathology DepartmentCentro Hospitalar de São JoãoPortoPortugal
  4. 4.Institute of Molecular Pathology and ImmunologyUniversity of PortoPortoPortugal

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