ABSTRACT
This chapter discusses the bacterial and viral pathogens associated with anorectal proctitis. Sexually transmitted infections (STIs) continue to be a tremendous health burden. The actual reported disease rates underestimate the true burden of infection because the majority of STIs are asymptomatic and underreported. Human immunodeficiency virus (HIV)-negative individuals who engage in ano-receptive intercourse are more prone to HIV infection in the presence of ulcerating anal STIs. In addition, recent data suggest that unprotected anal sex has become more common in all communities, and the incidence of sexually-transmitted proctitis and proctocolitis has increased in both the heterosexual and homosexual communities. Gonorrhoea infections are caused by Neisseria gonorrhoea, a Gram-negative diplococcus associated with exudative cervicitis and urethritis. Gonorrhoea affects the lining of the urethra, endocervix, rectum and pharynx. Syphilis is only transmitted when mucocutaneous lesions are present. Partners of patients with syphilis should be identified, as partner identification has been shown to reveal a large number of additional infected persons.
