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Gastrointestinal manifestations of sexually transmitted infections may not be early recognized. Given the increased high-risk sexual behavior, the recognition of infectious proctitis in the daily practice is imperative. The authors present a 28-year-old male patient infected with human immunodeficiency virus (with normal CD4+ count), who was admitted for several times to the emergency room due to rectal bleeding, purulent discharge, constipation with tenesmus, intense aerocoly and weight loss, with no improvement with support therapy. Rectosigmoidoscopy revealed an intense ulcerative proctitis with non-specific inflammation in histopathological analysis. Cytomegalovirus and Epstein-Barr virus DNA were positive in the following biopsy and specific therapy was started with delayed symptom and endoscopic resolution. This case enhances the complexity of proctitis diagnose and rises awareness of multiple sexually transmitted co-infections.
Received: 21/05/2016 - Accepted: 05/06/2016