Aspects cliniques et prise en charge des infections sexuellement transmissibles anorectales-Clinical aspects and management of anorectal manifestations of sexually transmitted infections

摘要

Diagnosis of anorectal manifestation of sexually transmitted infection can be challenging depending upon the background and the involved microbial agent. In any case, the fact that patients do complain from their anal and (or) rectal area must bring the practitioner to perform a proc-tologic examination which is always abnormal. Clinical examination is sufficient for diagnosing an infection due to Herpes but a serology is needed to make the diagnosis of syphilis, and rectal sampling is mandatory in case of proctitis assumed to be of bacterial etiology (gonococcus and/or chla-mydia). Management relies upon an antimicrobial treatment targeting the assumed or proved microbial agent. Herpes infections are treated with an antiviral drug (valaciclovir) so as to shorten and reduce the magnitude of symptoms. Supportive treatments are also welcome. Once evidenced, syphilis is classically treated with an injectable form of penicillin G. Any suspicion of bacterial proctitis generally leads to the prescription of a double antibiotic treatment both targeting gonococcus (3rd generation cephalosporin) and chla-mydia (cyclin). Clinical monitoring is always needed, associated with serological surveillance in case of syphilitic infection