Features and etiology of infectious proctitis in MSM. From PMID: 24275725
Thanks Dr. Jimenez for a great morning report discussing causes of infectious proctitis.
Learning points:
- Causes of rectal pain include infectious etiologies, IBD, trauma, anal fissures, hemorrhoids.
- In HIV-positive patients, consider gonorrhea, chlamydia (both LGV and non-LGV), HSV, CMV, entamoeba histolytica, and syphilis.
- When testing for stool OxP, collect three daily samples to increase yield.
- For eosinophilia, use the mnemonic NAACP (neoplasm, allergy/asthma, adrenal insufficiency, collagen vascular disease, parasites).
- If suspected, consider empirical treatment of gonorrhea+chlamydia with ceftriaxone 250mg IM x1 and doxycycline 100mg PO BID (covers both LGV and non-LGV chlamydia) while awaiting test results.