SNFGE SNFGE
 
Thématique :
- Colo-proctologie
Originalité :
Intermédiaire
Solidité :
Très solide
Doit faire évoluer notre pratique :
Immédiatement
 
 
Nom du veilleur :
Docteur Vincent de PARADES
Coup de coeur :
 
 
International Journal of Colorectal Disease
  2019/02  
 
  2019 Feb;34(2):359-362.  
  doi: 10.1007/s00384-018-3185-5.  
 
  Infectious proctitis: a necessary differential diagnosis in ulcerative colitis.  
 
  Santos AL, Coelho R, Silva M, Rios E, Macedo G  
  https://www.ncbi.nlm.nih.gov/pubmed/30402768  
 
 

Abstract

INTRODUCTION:

In the last years, there was a rising in the incidence of sexually transmitted infections, including proctitis. Infectious proctitis (IP), mainly caused by agents like Neisseria gonorrhea and Chlamydia trachomatis, is an entity that should be considered when patients with suspected inflammatory bowel disease (IBD) are approached, mainly if they have risk factors such as anal intercourse.

CLINICAL CASES/DISCUSSION:

The symptoms of IP, like rectal blood, mucous discharge, and anorectal pain, may appear in other causes of proctitis, like IBD. Therefore, to establish the diagnosis, it is crucial to take a detailed history and perform a physical examination, with the diagnosis being supported by complementary tests such as rectosigmoidoscopy, histology, serology, and culture. Depending on the etiology, treatment of IP is based in antibiotics or antivirals, which may be empirically initiated. Co-infections, mainly those that are sexually transmitted, and HIV should be tested and sexual partners should be treated, accordingly. In this article, the authors report three cases of IP, referent to three different patients, and review the initial approach required in cases where there is a clinical and/or endoscopic suspicion of this pathology.

 

 
Question posée
 
Décrire trois cas de rectite aiguë « MICI-like ».
 
Question posée
 
Il s’agissait d’un cas de gonococcie ano-rectale et de deux cas de lymphogranulomatose vénérienne.
 
Commentaires

Cas cliniques élémentaires mais essentiels pour penser (plus souvent) au diagnostic « curable » d’IST bactériennes (de plus en plus fréquentes) devant un tableau de rectite aiguë « MICI-like ».

 
 
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