Anorectal infections caused by sexually transmissible pathogens

Abstract

The authors present the case of a 20-year-old male patient, who was refered to their department by his family doctor with suspected drug allergy. He had several proctological examinations in the last half year, because of a chronic intermittently bleeding anal fissure, which has been treated with analgesic rectal cream and wound healing gel. During physical examination multiple maculopapular rash all over the body, infiltrated brownish papules on the soles and purulent discharge on the pharyngeal wall were detected. Differential diagnosis included secondary syphilis, viral exanthema and drug eruption. The syphilis serological tests confirmed the diagnosis of secondary syphilis. The patient received benzathine-penicillin treatment. Due to the non-healing anal fissure pelvic MR was performed, which did not reveal definitive fistula. Further STI screening tests showed Neisseria gonorrhoeae infection of the anus and after ceftriaxon administration the patient’s anorectal symptoms healed. Our case emphasizes the importance of sexually transmitted co-infections.