AM Report: HSV Proctitis

Etiology of proctitis

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.