Case 2-2006 -- A 31-Year-Old, HIV-Positive Man with Rectal Pain

doi:10.1056/NEJMcpc059038

Volume 354:284-289		January 19, 2006		Number 3

Case 2-2006 — A 31-Year-Old, HIV-Positive Man with Rectal Pain

Benjamin T. Davis, M.D., Michael Thiim, M.D., and Lawrence R. Zukerberg, M.D.

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Presentation of Case

A 31-year-old man with the acquired immunodeficiency syndrome(AIDS) was evaluated at the infectious disease clinic of thishospital because of rectal pain and a mucopurulent rectal discharge.

Four days before this evaluation, the patient first noticedrectal discharge, pain on defecation, and blood in his stools.He described pelvic pain, nausea, and generalized weakness butno fever, chills, or emesis. He had regular anal-receptive intercoursewithout condoms with his usual partner, who was also infectedwith the human immunodeficiency virus (HIV), and with otherpartners.

In the patient under discussion, HIV infection had been diagnosed12 years earlier. He . . . [Full Text of this Article]

Differential Diagnosis

Dr. Benjamin T. Davis's Diagnosis

Pathological Discussion

Anatomical Diagnosis

Source Information

From the Infectious Disease Unit (B.T.D.), the Gastrointestinal Unit (M.T.), and the Department of Pathology (L.R.Z.), Massachusetts General Hospital; and the Departments of Medicine (B.T.D., M.T.) and Pathology (L.R.Z.), Harvard Medical School.