直腸肛門の性感染症　　ＶＩ．消化器内科における経験から―アメーバ性大腸炎とクラミジア直腸炎について

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  • Sexually Transmitted Disease of the Anus and Rectum in the Department of Gastroenterology-Amebic Colitis and Chlamidia Trachomatis Proctitis

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This paper reports the characteristics of amebic colitis and Chlamydia trachomatis proctitis, which are representative sexually transmitted diseases of the rectum and anus encountered in the department of gastroenterology.<BR>Since amebic colitis is usually transmitted sexually among male homosexuals, it is essential to check patients with it for complications of other sexually transmitted diseases, especially HIV infection. The diagnosis of amebic colitis can be made endoscopically by experienced physicians. However, definitive diagnosis requires the combination of findings from biopsy with the results of serum antibody test, fecal tests and other examinations. Chlamydia tra-chomatis proctitis is a sexually transmitted infection encountered in male homosexuals and female heterosexuals. In Japan, it is relatively common among young females. Although it is currently considered rare overall, the possibility cannot be ruled out that there are many undetected cases of it, and its prevalence is expected to increase in the future. One endoscopic feature of it is salmon roe-shaped elevated lesions affecting the lower segment of the rectum, and inflammation of lymphatic follicles is a principal lesion in affected patients. Definitive diagnosis of this disease requires detection of Chlamydia trachomatis antigen or DNA by exfoliative cytodiagnosis of the rectum.

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