Proctocolitis caused by lymphogranuloma venereum

A 47-year-old man was referred to our anal dysplasia clinic for the evaluation of ongoing anorectal discomfort and an anal mass. The patient had experienced severe rectal pain and cramping and incomplete defecation, and had passed stools containing pus and blood. He also had intermittent fevers and difficulty starting and maintaining urine flow. These symptoms had caused him considerable distress and disruption to his daily life over the previous four months. The patient's medical history included HIV infection, for which he was receiving stable antiretroviral therapy. He also had a history of coronary artery disease, with two previous myocardial infarctions requiring percutaneous intervention. The rest of his medical history was noncontributory. Clinicians should suspect lymphogranuloma venereum proctitis when a patient presents with typical symptoms (rectal pain, abdominal cramping, discharge and bleeding ) and risk factors for anal chlamydia transmission, such as HIV infection, or a history of anal intercourse or same-sex male intercourse. Here, Weiss and Sano discuss proctocolitis caused by lymphogranuloma venereum.