CURRENT Diagnosis & Treatment of Sexually Transmitted Diseases
Chapter 9. Proctitis & Proctocolitis
Sections: Proctitis & Other Sexually Transmitted Intestinal Syndromes, Pathogens Causing Proctitis, Pathogens Causing Proctocolitis, Parasitic Infections, Practice Points, Relevant Web Sites.
Topics Discussed: proctitis; proctocolitis.
Excerpt:"Sexually transmitted intestinal infections may be transmitted
by direct rectal inoculation or indirectly in the course of oral-anal
contact. Conventional sexually transmitted diseases (STDs) most often
cause rectal infections through direct inoculation by anal intercourse,
although perineal contamination by cervicovaginal secretions among
women has been described. Chlamydia trachomatis and Neisseria gonorrhoeae infect columnar
epithelium and infect the anorectal mucosa via oral-genital and
rectal insertive intercourse. HSV, human papillomavirus, and Treponema pallidum infect stratified
squamous epithelium and can be transmitted similarly to the anorectal
region. Although not considered "classical" STDs,
enteric pathogens, parasites, and hepatitis A and B can be transmitted
during direct oral-anal contact, (anilingus) or during oral-genital
contact after rectal intercourse. Exposure to as few as 10100
organisms of Shigella, Entamoeba histolytica cysts, or Giardia lamblia cysts may precipitate
infection.Inflammation involving the rectal mucosa is termed proctitis. The perianal area up to
the anal verge is composed of keratinized, stratified squamous dermal epithelium.
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