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Saturday, June 6, 2009

Anorectal Infections

8:37 AM


DESCRIPTION

* These are infections of the anal and rectal tissues, causing the tissues in these areas to become inflamed. It is usually sexually transmitted, with the highest risk from anal intercourse.

SYMPTOMS

* Anorectal pain
* Severe rectal pain after a bowel movement
* Rectal discharge
* Constipation
* Anorectal itching/burning

CAUSE

* Neisseria gonorrhoeae (Gonorrhea)
* Treponema pallidum (syphilis)
* Chlamydia trachomatis (Chlamydia)
* Herpes Simplex virus
* Human papillomavirus

HOW THE DIAGNOSIS IS MADE

* Examination -- findings that may be present:



1. Redness of anal area
2. Pus expressed from crypts in anus
3. Chancre (painless ulcer) present in syphilis
4. Condylomata lata (moist warty patches) present in syphilis
5. Genital ulcers
6. Enlarged lymph nodes in groin
7. Blister lesions in anal or genital area
8. Warty areas (hard and thickened)

* Laboratory Tests:

1. Swab and culture of anal canal
2. Urethral or cervical cultures may be helpful
3. Dark-field microscopy (test for syphilis)
4. VDRL or RPR blood test for syphilis
5. Rectal biopsy
6. Viral culture or antigen detection of herpes lesions

TREATMENT

* Gonorrhea -- Ceftriaxone, ciprofloxacin
* Syphilis -- Penicillin G (injection), tetracycline, azithromycin
* Chlamydia -- Tetracycline, erythromycin, trimethoprim-sulfamethoxazole, azithromycin
* Herpes Simplex -- Acyclovir, Valtrex, Famvir
* Venereal Warts (human papillomavirus) -- topical Podophyllum resin, laser surgery, cryosurgery (freezing)

SIMILAR CONDITIONS

* Perianal Abscess
* Ulcerative Colitis
* Crohn's Disease


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