de Vries Henry J C, Zingoni Adele, White John A, Ross Jonathan D C, Kreuter Alexander
STI outpatient clinic, Cluster Infectious Diseases, Health Service Amsterdam, Amsterdam, The Netherlands Department of Dermatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands Centre for Infectious Diseases and Immunology Amsterdam (CINIMA), Amsterdam, The Netherlands Centre for Infectious Disease Control, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
Department of Biomedical Sciences and Human Oncology, Dermatologic Clinic, University of Turin, Turin, Italy.
Int J STD AIDS. 2014 Jun;25(7):465-74. doi: 10.1177/0956462413516100. Epub 2013 Dec 18.
Proctitis is defined as an inflammatory syndrome of the distal 10-12 cm of the anal canal, also called the rectum. Infectious proctitis can be sexually transmitted via genital-anal mucosal contact, but some also via mutual masturbation.N. gonorrhoeae,C. trachomatis(including lymphogranuloma venereum), Herpes Simplex Virus andT. pallidumare the most common sexually transmitted anorectal pathogens. Shigellosis can be transferred via oral-anal contact and may lead to proctocolitis or enteritis. Although most studies on these infections have concentrated on men who have sex with men (MSM), a significant proportion of women have anal intercourse and therefore may also be at risk. A presumptive clinical diagnosis of proctitis can be made when there are symptoms and signs, and a definitive diagnosis when the results of laboratory tests are available. The symptoms of proctitis include anorectal itching, pain, cramps (tenesmus) and discharge in and around the anal canal. Asymptomatic proctitis occurs frequently and can only be detected by laboratory tests. The majority of rectal chlamydia and gonococcal infections are asymptomatic. Therefore when there is a history of receptive anal contact, exclusion of anorectal infections is generally indicated as part of standard screening for sexually transmitted infections (STIs). Condom use does not guarantee protection from bacterial and protozoan STIs, which are often spread without penile penetration.
直肠炎被定义为肛管远端10 - 12厘米（即直肠）的炎症综合征。感染性直肠炎可通过生殖器 - 肛门黏膜接触性传播，但也有一些是通过相互手淫传播。淋病奈瑟菌、沙眼衣原体（包括性病性淋巴肉芽肿）、单纯疱疹病毒和梅毒螺旋体是最常见的性传播肛门直肠病原体。志贺菌病可通过口 - 肛接触传播，并可能导致直肠结肠炎或肠炎。尽管大多数关于这些感染的研究都集中在男男性行为者（MSM）身上，但相当一部分女性有肛交行为，因此也可能面临风险。当出现症状和体征时可做出直肠炎的初步临床诊断，有实验室检查结果时则可做出明确诊断。直肠炎的症状包括肛门直肠瘙痒、疼痛、痉挛（里急后重）以及肛管内外有分泌物。无症状性直肠炎很常见，只能通过实验室检查检测出来。大多数直肠衣原体和淋球菌感染是无症状的。因此，当有接受肛交的病史时，作为性传播感染（STIs）标准筛查的一部分，通常需要排除肛门直肠感染。使用避孕套并不能保证预防细菌和原生动物性传播感染，这些感染往往在没有阴茎插入的情况下传播。
