Chonnam Med J.  2015 Dec;51(3):139-141. 10.4068/cmj.2015.51.3.139.

Chlamydial Proctitis in a Young Man Who Has Sex with Men: Misdiagnosed as Inflammatory Bowel Disease

• Lee KJ
• Kim J
• Shin DH
• Jung JO
• Koh S
• Kim KY
• Lee JM

• KMID: 2172131
• DOI: http://doi.org/10.4068/cmj.2015.51.3.139

Abstract

We report the case of a 20-year-old man with a 2-month history of anal pain and bloody rectal discharge. He was referred to our clinic of gastroenterology for suspected inflammatory bowel disease (IBD). The colonoscopy showed mucosal nodularities on the rectum and an anal tag. Because the colonoscopic findings were not consistent with the typical manifestations of IBD, we took an additional sexual history and performed studies for infectious proctitis, including serologic tests for Chlamydia trachomatis, Neisseria gonorrhoeae, and Treponema pallidum. He had homosexual experience, and the serologic tests and PCR of a rectal swab were positive for C. trachomatis infection. Finally he was diagnosed as having chlamydial proctitis and was treated with intramuscular ceftriaxone 250 mg in a single dose and doxycycline 100 mg orally twice daily for 7 days. After 2 months, he had no lower abdominal symptoms and his endoscopic findings were improved.

Keyword

Proctitis; Chlamydia trachomatis; Inflammatory bowel diseases; Lymphogranuloma venereum; Sexually transmitted diseases

MeSH Terms

Ceftriaxone
Chlamydia trachomatis
Colonoscopy
Doxycycline
Gastroenterology
Homosexuality
Humans
Inflammatory Bowel Diseases*
Lymphogranuloma Venereum
Male
Neisseria gonorrhoeae
Polymerase Chain Reaction
Proctitis*
Rectum
Serologic Tests
Sexually Transmitted Diseases
Treponema pallidum
Young Adult
Ceftriaxone
Doxycycline