Rectal Symptoms in MSM

  • STIs which can affect the anal canal/rectum (proctitis) include
    • Gonorrhoea
    • Chlamydia (LGV strains and classic strains)
    • Herpes simplex
    • Syphilis (may cause painful ulceration)
  • Symptoms may include
    • mucopurulent anal discharge
    • rectal bleeding
    • pain
    • tenesmus
    • there may also be a history of GI symptoms e.g. diarrhoea (due to campylobacter, shigella..)
  • On examination, there may be erythema, contact bleeding
  • Take a history of presenting complaint; PMHx; SHx and full sexual history; Contact Hx
  • Rectal swab for chlamydia and gonorrhoea +/- HSV PCR would be routine

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