A 26-year-old man presents with fevers and bloody stools. Explore the Differential Diagnosis of acute proctitis, from IBD to infectious causes.
A 26-year-old man presented with a 1-week history of fevers and bloody stools. On physical examination, there was a small external hemorrhoid but no abdominal pain, genital lesions, or inguinal lymphadenopathy. Computed tomography of the pelvis showed thickening of the wall of the rectum (left) and perirectal lymphadenopathy. A subsequent flexible sigmoidoscopy showed nodular mucosa with erythema and ulceration in the distal rectum (right). After a tissue biopsy of the lesion, which of the following is the most appropriate next step?
What is the most likely diagnosis?
Chlamydia trachomatis, HIV, Proctitis, Rectal swab for sexually transmitted infections, Sexually Transmitted Infections
