A Gay Man Requesting a Sexual Health Screen
As in Case 1,a specific history should be taken to elicit any symptoms that the individual may not have recognized as being those of a sexually transmissible infection (STI). In addition to the questions posed in that Case, he should be asked if he has symptoms suggestive of distal proctitis: anal discharge or streaking of the stool with “slime,” anorectal bleeding, perianal pain, constipation, or a feeling of incomplete defecation. He should also be asked if he has a sore throat. Gonococcal infection of the pharynx is usually symptomless, but a few men (and women) complain of sore throat. (Although there is a good correlation between pharyngeal symptoms and fellatio, this is not the case with respect to gonococcal infection).