Spornraft-Ragaller P, Esser S
Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland.
Klinik für Dermatologie und Venerologie, Universitätsklinikum Essen, Essen, Deutschland.
Hautarzt. 2020 Apr;71(4):275-283. doi: 10.1007/s00105-020-04547-w.
Sexually transmitted infections (STIs) in the anorectal region are disproportionally detected in risk populations such as men who have sex with men (MSM). However, due to changes in sexual behaviour they are increasingly diagnosed in heterosexual individuals. Due to the recent implementation of oral HIV pre-exposure prophylaxis together with lack of condom use, a further rise in STIs is expected.
This review addresses epidemiology, clinical picture, diagnostic pitfalls and current therapy guidelines of "classical" bacterial STIs involving the anorectum.
STI manifestations in the anal region are frequently nonspecific or asymptomatic so that the diagnosis may be missed. In an endoscopic examination of the rectum, they can even mimic inflammatory bowel disease or malignancy. Therefore, knowledge of possible symptoms of bacterial STIs in this area is helpful for early diagnosis. Coinfections with other STIs are common and should prompt a search of other pathogens including HIV and hepatitis B/C.
肛门直肠区域的性传播感染(STIs)在男男性行为者(MSM)等高危人群中被检出的比例过高。然而,由于性行为的变化,它们在异性恋个体中的诊断越来越多。由于最近开始实施口服HIV暴露前预防措施以及缺乏避孕套的使用,预计性传播感染会进一步增加。
本综述阐述了累及肛门直肠的“经典”细菌性性传播感染的流行病学、临床表现、诊断陷阱和当前治疗指南。
肛门区域的性传播感染表现通常是非特异性的或无症状的,因此可能会漏诊。在直肠内镜检查中,它们甚至可能类似炎症性肠病或恶性肿瘤。因此,了解该区域细菌性性传播感染的可能症状有助于早期诊断。与其他性传播感染的合并感染很常见,应促使对包括HIV和乙型/丙型肝炎在内的其他病原体进行排查。