Dhawan Benu, Makharia Govind Kumar, Juyal Deepak, Sebastian Sujeesh, Bhatia Riti, Khanna Neena
Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India.
Indian J Pathol Microbiol. 2017 Apr-Jun;60(2):259-261. doi: 10.4103/IJPM.IJPM_114_16.
While proctitis is caused both by infectious and noninfectious causes, infectious causes are acquired typically sexually. Chlamydia trachomatis, which is the most frequent bacterial pathogen causing sexually transmitted infections worldwide, is one of the causative agents of proctitis. We report a case history of a bisexual male who presented to us with rectal bleeding. The colonoscopy showed a nodular ulcerated lesion in the rectum suggestive of rectal malignancy, but biopsies from rectal mass did not reveal malignancy. A rectal biopsy was positive for C. trachomatis by polymerase chain reaction assay, and a diagnosis of C. trachomatis proctitis was made. Considering the invasive anorectal disease and patient's sexual history, he was treated with prolonged doxycycline therapy as per Centres for Disease Control and Prevention's treatment recommendation for lymphogranuloma venereum. A high index of clinical suspicion along with appropriate microbiological testing can clinch the diagnosis of C. trachomatis infection.
虽然直肠炎可由感染性和非感染性原因引起,但感染性原因通常是通过性传播获得的。沙眼衣原体是全球最常见的引起性传播感染的细菌病原体,是直肠炎的病原体之一。我们报告一例双性恋男性病例,该患者因直肠出血前来就诊。结肠镜检查显示直肠有一个结节状溃疡性病变,提示直肠恶性肿瘤,但直肠肿物活检未发现恶性肿瘤。通过聚合酶链反应检测,直肠活检沙眼衣原体呈阳性,诊断为沙眼衣原体直肠炎。考虑到侵袭性肛肠疾病和患者的性病史,根据疾病控制与预防中心对性病性淋巴肉芽肿的治疗建议,对他进行了长期强力霉素治疗。高度的临床怀疑以及适当的微生物检测可以确诊沙眼衣原体感染。