- Secondary syphillis
- Chlamydia trachomatis (lymphogranuloma venereum - LGV)
- Herpes simplex virus (HSV)
- Entamoeba histolytica (amebiasis)
- + sexual active
- Hx past STI
- Peri-rectal pain
- Sometimes anal d/c
- Genital or peri-rectal ulcers
- Peri-rectal inflammation, ulcers, d/c, fissure
- Ulcers and/or inflammation can be higher up rectal canal and not visible on external exam→visible via lower endoscopy
- Condyloma lata w/syphilis
- Assess for evidence co-infxns that travel w/STIs→ hpv, hiv
- May need sigmoidoscopy to see lesions higher up rectal canal (if suggestive symptoms but no external findings)