Clinical analysis of 6 cases of proctitis caused by sexually transmitted infections

[Objective] To analyze the clinical manifestations, characteristics, and the diagnosis and treatment of proctitis caused by sexually transmitted infections. [Methods] Clinical data from patients with anal pain as the primary symptom were collected and analyzed at the anorectal emergency department of Beijing Anorectal Hospital between January 2023 and November 2023. [Results] All six patients were young men who had sex with men, and two were diagnosed with HIV infection. All patients had a history of anal intercourse 1-2 weeks before the onset of the disease. All patients presented with anal pain as the primary symptom. Physical examination revealed swelling of the anal canal. Digital rectal examination revealed purulent secretions. Five cases experienced low fever, and 2 cases had rectal ulcers. Three cases were positive for Chlamydia trachomatis, 2 cases were positive for Neisseria gonorrhoeae, and 1 case was positive for both Chlamydia trachomatis and Neisseria gonorrhoeae. Three cases showed abnormal hypoechogenicity on rectal ultrasound. In terms of the treatment, intramuscular injection of ceftriaxone or intravenous infusion of moxifloxacin, and a homemade topical ointment were given. All patients recovered after 2-week treatment. [Conclusions] Proctitis caused by sexually transmitted infections is relatively rare in clinical practice, and it has no typical characteristics. Clinicians should pay attention to a detailed medical history and avoid misdiagnosis and mistreatment.