Etiology of clinical proctitis among men who have sex with men.
Abstract
In this retrospective review of cases of clinical proctitis, we identified the frequency of common sexually transmitted diseases (STDs) among men who have sex with men on the basis of reports from the municipal STD clinic in San Francisco. Of note, gonorrhea and chlamydia were the most common STDs, followed by herpes and syphilis. Current STD treatment guidelines recommend empiric treatment for gonorrhea and chlamydia, but treatment for herpes should also be considered. The implications for human immunodeficiency virus (HIV) transmission are also discussed.
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Acute proctitis among persons who have anal exposure through oral, genital, or digital contact is usually sexually acquired.
“Acute proctitis among persons who have anal exposure through oral, genital, or digital contact is usually sexually acquired (1382,1388).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [1388]
Cites
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“Pallidum.(14,162,174,175) Patients with proctitis should be tested for HIV, hepatitis C, and hepatitis A & B if non-immune, as per BASHH guidelines.”
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“P that cause proctitis include Neisseria gonorrhoeae, Chlamydia trachomatis, Treponema pallidum, and herpes simplex virus (1).”
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“often caused by organisms that are sexually transmitted, most commonly Neisseria gonorrhoeae (30%) and Chlamydia trachomatis (19%), followed by herpes simplex virus 2 (16%) and syphilis (2%).(22,23) Other rare causes of infectious proctitis include amebiasis and Mycoplasma genitalium.”
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“Anorectal STIs are common in MSM and may increase the risk of HIV transmission 63–65 (figure 1 ).”
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“Co-infections were not uncommon, 10% of the patients with infectious proctitis tested positive for multiple pathogens [4].”
BackgroundMechanisms, management and prevention of anorectal sexually transmitted infections
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“A defining review described the microbiologic etiologies of proctitis among symptomaticMSM in an STD clinic in San Francisco from 2001 to 2002; in that cohort, 55% had an identified pathogen, with the majority of cases due to GC (20%) followed by CT (11%) and HSV (13%).(6) To our knowledge, no updated reports on proct…”
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“Syphilis proctitis is a rare presentation of syphilis infection and only causes 1% of infective proctitis overall [97,98].”
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“gonorrhea were seen in up to one-third of MSM who present with any rectal symptoms”
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Entamoeba histolytica‐associated proctitis and ileitis mimicking Crohn's disease—A case report
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“Syphilis is the cause of sexually transmitted proctitis in only 1% of MSM and transgender females [1].”
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CT findings of proctitis in two patients with Mpox
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“In both patients, common infectious causes of proctitis including sexually transmitted infections (STIs) such as gonorrhea, chlamydia, syphilis, and HPV were ruled out [6, 11].”
BackgroundDermatologic Complications of HIV
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Plasmablastic Lymphoma Masquerading as Perianal Abscess in a Homosexual Man
Rapose, A., & Naniwadekar, A. S. (2009) · Infectious Diseases in Clinical Practice · doi:10.1097/ipc.0b013e31818d1aee · Cited by 1 · see citing works
“who have anal intercourse, sexually transmitted infections also need to be considered, and organisms associated with sexually transmitted proctitis have been reviewed.(5,6) More recently, there has been an increase in the incidence of unprotected anal intercourse among homosexual men with an associated increased incid…”
BackgroundHistologic mimics of inflammatory bowel disease
Zhao, L., & Hart, J. A. L. (2014) · Seminars in Diagnostic Pathology · doi:10.1053/j.semdp.2014.02.003 · Cited by 1 · see citing works
A couplet: a case of anal ulceration and another of inguinal swelling
Chen, M. Y., Read, T. R. H., Leslie, D. E., & Bissessor, M. (2011) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.2011.tb03191.x · Cited by 1 · see citing works
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Syphilitic proctitis:a Case Report and Review of the Literature
Lv, L., Liu, G., Jie, X., Luo, J., Peng, L., Ding, Y., & Shi, W. (2024) · Revista Española de Enfermedades Digestivas · doi:10.17235/reed.2024.10334/2024 · Cited by 1 · see citing works
Nanomedicine in the development of vaccines against Herpesviridae: a narrative review
Lee, D. H.-Y., Lee, W., & Bach, H. (2025) · Nanomedicine · doi:10.1080/17435889.2025.2587714 · Cited by 1 · see citing works
Antiviral therapy for genital herpes for prevention of HIV transmission
Ng, B., Rutherford, G. W., Broad, A. L., & Moore, D. M. (2011) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006492.pub2 · Cited by 1 · see citing works
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Acute Cytomegalovirus Proctitis in an Immunocompetent Man After Receptive Anal Intercourse
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Cazalilla, M. S., & Aguilar, F. C. (2008) · Medicine - Programa de Formación Médica Continuada Acreditado · doi:10.1016/s0211-3449(08)72939-4
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- Authors
- Klausner, J. D., Kohn, R., & Kent, C.
- Affiliations
- University of California, San Francisco (US)
- San Francisco Department of Public Health (US)
- Corresponding author
- Klausner, Jeffrey D.
- ORCID
- Klausner, Jeffrey D.
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2004-01-15
- Volume
- 38
- Issue
- 2
- Pages
- 300-302
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2117345740
- Cited by
- 129
- References
- 8
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 6 · 2023: 8 · 2022: 3 · 2021: 7 · 2020: 4 · 2019: 5 · 2018: 5 · 2017: 5 · 2016: 5 · 2015: 5 · 2014: 3 · 2013: 4 · 2012: 3
- FWCI
- 4.88
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Epidemiology › Herpesvirus Infections and Treatments
- Keywords
- proctitis, men who have sex with men, sexually transmitted infections, gonorrhea, chlamydia, herpes, syphilis, empirical treatment, HIV transmission
- MeSH terms
- Adolescent, Adult, Chlamydia Infections, Gonorrhea, HIV, Humans, Male, Middle Aged, Proctitis, Sexually Transmitted Diseases, Syphilis, Homosexuality, Male
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