title: Chlamydial Proctitis in a Young Man Who Has Sex with Men: Misdiagnosed as Inflammatory Bowel Disease.
abstract: We report the case of a 20-year-old man with a 2-month history of anal pain and bloody rectal discharge. He was referred to our clinic of gastroenterology for suspected inflammatory bowel disease (IBD). The colonoscopy showed mucosal nodularities on the rectum and an anal tag. Because the colonoscopic findings were not consistent with the typical manifestations of IBD, we took an additional sexual history and performed studies for infectious proctitis, including serologic tests for Chlamydia trachomatis, Neisseria gonorrhoeae, and Treponema pallidum. He had homosexual experience, and the serologic tests and PCR of a rectal swab were positive for C. trachomatis infection. Finally he was diagnosed as having chlamydial proctitis and was treated with intramuscular ceftriaxone 250 mg in a single dose and doxycycline 100 mg orally twice daily for 7 days. After 2 months, he had no lower abdominal symptoms and his endoscopic findings were improved.
authors.affiliation: Department of Internal Medicine, National Police Hospital, Seoul, Korea.
authors.forename: Kyung Jin
authors.initials: KJ
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, National Police Hospital, Seoul, Korea.
authors.forename: Jaeyeon
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, National Police Hospital, Seoul, Korea.
authors.forename: Dong Hwan
authors.initials: DH
authors.lastname: Shin
authors.affiliation: Department of Internal Medicine, National Police Hospital, Seoul, Korea.
authors.forename: Jun Oh
authors.initials: JO
authors.lastname: Jung
authors.affiliation: Department of Internal Medicine, National Police Hospital, Seoul, Korea.
authors.forename: Seokyoung
authors.initials: S
authors.lastname: Koh
authors.affiliation: Department of Internal Medicine, National Police Hospital, Seoul, Korea.
authors.forename: Ka Young
authors.initials: KY
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, National Police Hospital, Seoul, Korea.
authors.forename: Jae Min
authors.initials: JM
authors.lastname: Lee
keywords: Chlamydia trachomatis; Inflammatory bowel diseases; Lymphogranuloma venereum; Proctitis; Sexually transmitted diseases