Skip to main content
SpringerLink
Log in

Sexually Transmitted Infections

  • Chapter
  • First Online:
The ASCRS Textbook of Colon and Rectal Surgery

  • 66k Accesses

Abstract

Colorectal surgeons must be familiar with the diagnosis and management of sexually transmitted infections, as their symptoms overlap with common colorectal diseases such as fissure, hemorrhoid, cancer, and inflammatory bowel disease. Eliciting a complete sexual history is paramount, as is maintaining a high level of suspicion for these infections. Empiric treatment is generally recommended, especially for symptomatic patients. Management of sexually transmitted infections requires not only prescribing the recommended medical therapy but also ensuring that sexual partners are notified, counseling patients to reduce their risk of transmission and reinfection, and notifying health departments of new cases and treatment failures.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Mimiaga MJ, Helms DJ, Reisner SL, Grasso C, Bertrand T, Mosure DJ, et al. Gonococcal, chlamydia, and syphilis infection positivity among MSM attending a large primary care clinic, Boston, 2003 to 2004. Sex Transm Dis. 2009;36(8):507–11.

    PubMed  Google Scholar 

  2. van Liere GA, Hoebe CJ, Niekamp AM, Koedijk FD, Dukers-Muijrers NH. Standard symptom- and sexual history-based testing misses anorectal Chlamydia trachomatis and neisseria gonorrhoeae infections in swingers and men who have sex with men. Sex Transm Dis. 2013;40(4):285–9.

    PubMed  Google Scholar 

  3. van Liere GA, Hoebe CJ, Dukers-Muijrers NH. Evaluation of the anatomical site distribution of chlamydia and gonorrhea in men who have sex with men and in high-risk women by routine testing: cross-sectional study revealing missed opportunities for treatment strategies. Sex Transm Infect. 2014;90(1):58–60.

    PubMed  Google Scholar 

  4. Bissessor M, Fairley CK, Read T, Denham I, Bradshaw C, Chen M. The etiology of infectious proctitis in men who have sex with men differs according to HIV status. Sex Transm Dis. 2013;40(10):768–70.

    PubMed  Google Scholar 

  5. Zakher B, Cantor AG, Pappas M, Daeges M, Nelson HD. Screening for gonorrhea and Chlamydia: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 2014;161(12):884–93.

    PubMed  Google Scholar 

  6. Prevention CfDCa. Recommendations for the laboratory-based detection of Chlamydia trachomatis and Neisseria gonorrhoeae – 2014. MMWR Recomm Rep. 2014;63(RR-02):1–19.

    Google Scholar 

  7. Workowski KA, Berman SM, Douglas JM. Emerging antimicrobial resistance in Neisseria gonorrhoeae: urgent need to strengthen prevention strategies. Ann Intern Med. 2008;148(8):606–13.

    PubMed  Google Scholar 

  8. (CDC) CfDCaP. Update to CDC’s sexually transmitted diseases treatment guidelines, 2010: oral cephalosporins no longer a recommended treatment for gonococcal infections. MMWR Morb Mortal Wkly Rep. 2012;61(31):590–4.

    Google Scholar 

  9. Bolan GA, Sparling PF, Wasserheit JN. The emerging threat of untreatable gonococcal infection. N Engl J Med. 2012;366(6):485–7.

    PubMed  Google Scholar 

  10. (CDC) CfDCaP. Cephalosporin susceptibility among Neisseria gonorrhoeae isolates – United States, 2000–2010. MMWR Morb Mortal Wkly Rep. 2011;60(26):873–7.

    Google Scholar 

  11. Kirkcaldy RD, Zaidi A, Hook EW, Holmes KK, Holmes KH, Soge O, et al. Neisseria gonorrhoeae antimicrobial resistance among men who have sex with men and men who have sex exclusively with women: the Gonococcal Isolate Surveillance Project, 2005–2010. Ann Intern Med. 2013;158(5 Pt 1):321–8.

    PubMed  PubMed Central  Google Scholar 

  12. Kovari H, de Melo Oliveira MD, Hauser P, Läuchli S, Meyer J, Weber R, et al. Decreased susceptibility of Neisseria gonorrhoeae isolates from Switzerland to Cefixime and Ceftriaxone: antimicrobial susceptibility data from 1990 and 2000 to 2012. BMC Infect Dis. 2013;13:603.

    PubMed  PubMed Central  Google Scholar 

  13. van Liere GA, Hoebe CJ, Wolffs PF, Dukers-Muijrers NH. High co-occurrence of anorectal chlamydia with urogenital chlamydia in women visiting an STI clinic revealed by routine universal testing in an observational study; a recommendation towards a better anorectal chlamydia control in women. BMC Infect Dis. 2014;14:274.

    PubMed  PubMed Central  Google Scholar 

  14. LeFevre ML. Force USPST. Screening for Chlamydia and gonorrhea: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2014;161(12):902–10.

    PubMed  Google Scholar 

  15. Geisler WM. Diagnosis and management of uncomplicated Chlamydia trachomatis infections in adolescents and adults: summary of evidence reviewed for the 2010 Centers for Disease Control and Prevention sexually transmitted diseases treatment guidelines. Clin Infect Dis. 2011;53 Suppl 3:S92–8.

    PubMed  Google Scholar 

  16. Van der Bij AK, Spaargaren J, Morré SA, Fennema HS, Mindel A, Coutinho RA, et al. Diagnostic and clinical implications of anorectal lymphogranuloma venereum in men who have sex with men: a retrospective case-control study. Clin Infect Dis. 2006;42(2):186–94.

    PubMed  Google Scholar 

  17. Stamm WE, Hicks CB, Martin DH, Leone P, Hook EW, Cooper RH, et al. Azithromycin for empirical treatment of the nongonococcal urethritis syndrome in men. A randomized double-blind study. JAMA. 1995;274(7):545–9.

    CAS  PubMed  Google Scholar 

  18. Workowski KA, Berman S, (CDC) CfDCaP. Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep. 2010;59(RR-12):1–110.

    PubMed  Google Scholar 

  19. Stamm WE, Batteiger BE, McCormack WM, Totten PA, Sternlicht A, Kivel NM, et al. A randomized, double-blind study comparing single-dose rifalazil with single-dose azithromycin for the empirical treatment of nongonococcal urethritis in men. Sex Transm Dis. 2007;34(8):545–52.

    CAS  PubMed  Google Scholar 

  20. Martin-Iguacel R, Llibre JM, Nielsen H, Heras E, Matas L, Lugo R, et al. Lymphogranuloma venereum proctocolitis: a silent endemic disease in men who have sex with men in industrialised countries. Eur J Clin Microbiol Infect Dis. 2010;29(8):917–25.

    CAS  PubMed  Google Scholar 

  21. Gallegos M, Bradly D, Jakate S, Keshavarzian A. Lymphogranuloma venereum proctosigmoiditis is a mimicker of inflammatory bowel disease. World J Gastroenterol. 2012;18(25):3317–21.

    PubMed  PubMed Central  Google Scholar 

  22. Arnold CA, Limketkai BN, Illei PB, Montgomery E, Voltaggio L. Syphilitic and lymphogranuloma venereum (LGV) proctocolitis: clues to a frequently missed diagnosis. Am J Surg Pathol. 2013;37(1):38–46.

    PubMed  Google Scholar 

  23. Soni S, Srirajaskanthan R, Lucas SB, Alexander S, Wong T, White JA. Lymphogranuloma venereum proctitis masquerading as inflammatory bowel disease in 12 homosexual men. Aliment Pharmacol Ther. 2010;32(1):59–65.

    CAS  PubMed  Google Scholar 

  24. Pathela P, Blank S, Schillinger JA. Lymphogranuloma venereum: old pathogen, new story. Curr Infect Dis Rep. 2007;9(2):143–50.

    PubMed  Google Scholar 

  25. de Vries HJ, van der Bij AK, Fennema JS, Smit C, de Wolf F, Prins M, et al. Lymphogranuloma venereum proctitis in men who have sex with men is associated with anal enema use and high-risk behavior. Sex Transm Dis. 2008;35(2):203–8.

    PubMed  Google Scholar 

  26. Mattei PL, Beachkofsky TM, Gilson RT, Wisco OJ. Syphilis: a reemerging infection. Am Fam Physician. 2012;86(5):433–40.

    PubMed  Google Scholar 

  27. Patton ME, Su JR, Nelson R, Weinstock H, (CDC) CfDCaP. Primary and secondary syphilis – United States, 2005–2013. MMWR Morb Mortal Wkly Rep. 2014;63(18):402–6.

    PubMed  PubMed Central  Google Scholar 

  28. Lynn WA, Lightman S. Syphilis and HIV: a dangerous combination. Lancet Infect Dis. 2004;4(7):456–66.

    CAS  PubMed  Google Scholar 

  29. Kemp M, Christensen JJ, Lautenschlager S, Vall-Mayans M, Moi H. European guideline for the management of chancroid, 2011. Int J STD AIDS. 2011;22(5):241–4.

    CAS  PubMed  Google Scholar 

  30. Lewis DA. Epidemiology, clinical features, diagnosis and treatment of Haemophilus ducreyi – a disappearing pathogen? Expert Rev Anti Infect Ther. 2014;12(6):687–96.

    CAS  PubMed  Google Scholar 

  31. Ernst AA, Marvez-Valls E, Martin DH. Incision and drainage versus aspiration of fluctuant buboes in the emergency department during an epidemic of chancroid. Sex Transm Dis. 1995;22(4):217–20.

    CAS  PubMed  Google Scholar 

  32. Basta-Juzbašić A, Čeović R. Chancroid, lymphogranuloma venereum, granuloma inguinale, genital herpes simplex infection, and molluscum contagiosum. Clin Dermatol. 2014;32(2):290–8.

    PubMed  Google Scholar 

  33. Barroso LF, Wispelwey B. Donovanosis presenting as a pelvic mass mimicking ovarian cancer. South Med J. 2009;102(1):104–5.

    PubMed  Google Scholar 

  34. Sethi S, Sarkar R, Garg V, Agarwal S. Squamous cell carcinoma complicating donovanosis not a thing of the past! Int J STD AIDS. 2014;25(12):894–7.

    PubMed  Google Scholar 

  35. Sardana K, Garg VK, Arora P, Khurana N. Malignant transformation of donovanosis (granuloma inguinale) in a HIV-positive patient. Dermatol Online J. 2008;14(9):8.

    PubMed  Google Scholar 

  36. Bradley H, Markowitz LE, Gibson T, McQuillan GM. Seroprevalence of herpes simplex virus types 1 and 2 – United States, 1999–2010. J Infect Dis. 2014;209(3):325–33.

    PubMed  Google Scholar 

  37. Xu F, Sternberg MR, Kottiri BJ, McQuillan GM, Lee FK, Nahmias AJ, et al. Trends in herpes simplex virus type 1 and type 2 seroprevalence in the United States. JAMA. 2006;296(8):964–73.

    CAS  PubMed  Google Scholar 

  38. Ryder N, Jin F, McNulty AM, Grulich AE, Donovan B. Increasing role of herpes simplex virus type 1 in first-episode anogenital herpes in heterosexual women and younger men who have sex with men, 1992–2006. Sex Transm Infect. 2009;85(6):416–9.

    CAS  PubMed  Google Scholar 

  39. Fanfair RN, Zaidi A, Taylor LD, Xu F, Gottlieb S, Markowitz L. Trends in seroprevalence of herpes simplex virus type 2 among non-Hispanic blacks and non-Hispanic whites aged 14 to 49 years – United States, 1988 to 2010. Sex Transm Dis. 2013;40(11):860–4.

    PubMed  Google Scholar 

  40. Mertz GJ. Asymptomatic shedding of herpes simplex virus 1 and 2: implications for prevention of transmission. J Infect Dis. 2008;198(8):1098–100.

    PubMed  Google Scholar 

  41. Mark KE, Wald A, Magaret AS, Selke S, Olin L, Huang ML, et al. Rapidly cleared episodes of herpes simplex virus reactivation in immunocompetent adults. J Infect Dis. 2008;198(8):1141–9.

    PubMed  Google Scholar 

  42. Mark KE, Wald A, Magaret AS, Selke S, Kuntz S, Huang ML, et al. Rapidly cleared episodes of oral and anogenital herpes simplex virus shedding in HIV-infected adults. J Acquir Immune Defic Syndr. 2010;54(5):482–8.

    PubMed  PubMed Central  Google Scholar 

  43. Le Cleach L, Trinquart L, Do G, Maruani A, Lebrun-Vignes B, Ravaud P, et al. Oral antiviral therapy for prevention of genital herpes outbreaks in immunocompetent and nonpregnant patients. Cochrane Database Syst Rev. 2014;8, CD009036.

    Google Scholar 

  44. Corey L, Wald A, Patel R, Sacks SL, Tyring SK, Warren T, et al. Once-daily valacyclovir to reduce the risk of transmission of genital herpes. N Engl J Med. 2004;350(1):11–20.

    CAS  PubMed  Google Scholar 

  45. Martin ET, Krantz E, Gottlieb SL, Magaret AS, Langenberg A, Stanberry L, et al. A pooled analysis of the effect of condoms in preventing HSV-2 acquisition. Arch Intern Med. 2009;169(13):1233–40.

    PubMed  PubMed Central  Google Scholar 

  46. Zuckerman RA, Lucchetti A, Whittington WL, Sanchez J, Coombs RW, Zuñiga R, et al. Herpes simplex virus (HSV) suppression with valacyclovir reduces rectal and blood plasma HIV-1 levels in HIV-1/HSV-2-seropositive men: a randomized, double-blind, placebo-controlled crossover trial. J Infect Dis. 2007;196(10):1500–8.

    CAS  PubMed  Google Scholar 

  47. Zuckerman RA, Lucchetti A, Whittington WL, Sánchez J, Coombs RW, Magaret A, et al. HSV suppression reduces seminal HIV-1 levels in HIV-1/HSV-2 co-infected men who have sex with men. AIDS. 2009;23(4):479–83.

    CAS  PubMed  Google Scholar 

  48. Mugwanya K, Baeten JM, Mugo NR, Irungu E, Ngure K, Celum C. High-dose valacyclovir HSV-2 suppression results in greater reduction in plasma HIV-1 levels compared with standard dose acyclovir among HIV-1/HSV-2 coinfected persons: a randomized, crossover trial. J Infect Dis. 2011;204(12):1912–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  49. Perti T, Saracino M, Baeten JM, Johnston C, Diem K, Ocbamichael N, et al. High-dose valacyclovir decreases plasma HIV-1 RNA more than standard-dose acyclovir in persons coinfected with HIV-1 and HSV-2: a randomized crossover trial. J Acquir Immune Defic Syndr. 2013;63(2):201–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  50. Nagot N, Ouédraogo A, Foulongne V, Konaté I, Weiss HA, Vergne L, et al. Reduction of HIV-1 RNA levels with therapy to suppress herpes simplex virus. N Engl J Med. 2007;356(8):790–9.

    CAS  PubMed  Google Scholar 

  51. Baggaley RF, Griffin JT, Chapman R, Hollingsworth TD, Nagot N, Delany S, et al. Estimating the public health impact of the effect of herpes simplex virus suppressive therapy on plasma HIV-1 viral load. AIDS. 2009;23(8):1005–13.

    PubMed  Google Scholar 

  52. Chin-Hong PV, Berry JM, Cheng SC, Catania JA, Da Costa M, Darragh TM, et al. Comparison of patient- and clinician-collected anal cytology samples to screen for human papillomavirus-associated anal intraepithelial neoplasia in men who have sex with men. Ann Intern Med. 2008;149(5):300–6.

    PubMed  Google Scholar 

  53. Guimarães AG, da Costa AG, Martins-Filho OA, Pimentel JP, Zauli DA, Peruhype-Magalhães V, et al. CD11c + CD123Low dendritic cell subset and the triad TNF-α/IL-17A/IFN-γ integrate mucosal and peripheral cellular responses in HIV patients with high-grade anal intraepithelial neoplasia: a systems biology approach. J Acquir Immune Defic Syndr. 2015;68(2):112–22.

    Google Scholar 

  54. Yaghoobi M, Le Gouvello S, Aloulou N, Duprez-Dutreuil C, Walker F, Sobhani I. FoxP3 overexpression and CD1a + and CD3+ depletion in anal tissue as possible mechanisms for increased risk of human papillomavirus-related anal carcinoma in HIV infection. Colorectal Dis. 2011;13(7):768–73.

    CAS  PubMed  Google Scholar 

  55. Guimarães AG, Silva Junior RM, Costa OT, Silva IT, Gimenez FS, Araujo JR, et al. Morphometric analysis of dendritic cells from anal mucosa of HIV-positive patients and the relation to intraepithelial lesions and cancer seen at a tertiary health institution in Brazil. Acta Cir Bras. 2011;26(6):521–9.

    PubMed  Google Scholar 

  56. Sobhani I, Walker F, Aparicio T, Abramowitz L, Henin D, Cremieux AC, et al. Effect of anal epidermoid cancer-related viruses on the dendritic (Langerhans’) cells of the human anal mucosa. Clin Cancer Res. 2002;8(9):2862–9.

    PubMed  Google Scholar 

  57. Bean SM, Chhieng DC. Anal-rectal cytology: a review. Diagn Cytopathol. 2010;38(7):538–46.

    PubMed  Google Scholar 

  58. Goldstone SE, Johnstone AA, Moshier EL. Long-term outcome of ablation of anal high-grade squamous intraepithelial lesions: recurrence and incidence of cancer. Dis Colon Rectum. 2014;57(3):316–23.

    PubMed  Google Scholar 

  59. Burgos J, Curran A, Tallada N, Guelar A, Navarro J, Landolfi S, et al. Risk of progression to high-grade anal intraepithelial neoplasia in HIV-infected MSM. AIDS. 2015;29(6):695–702.

    Google Scholar 

  60. Tong WW, Jin F, McHugh LC, Maher T, Sinclair B, Grulich AE, et al. Progression to and spontaneous regression of high-grade anal squamous intraepithelial lesions in HIV-infected and uninfected men. AIDS. 2013;27(14):2233–43.

    PubMed  Google Scholar 

  61. Sendagorta E, Herranz P, Guadalajara H, Bernardino JI, Viguer JM, Beato MJ, et al. Prevalence of abnormal anal cytology and high-grade squamous intraepithelial lesions among a cohort of HIV-infected men who have sex with men. Dis Colon Rectum. 2014;57(4):475–81.

    PubMed  Google Scholar 

  62. Darwich L, Videla S, Cañadas MP, Piñol M, García-Cuyàs F, Vela S, et al. Distribution of human papillomavirus genotypes in anal cytological and histological specimens from HIV-infected men who have sex with men and men who have sex with women. Dis Colon Rectum. 2013;56(9):1043–52.

    PubMed  Google Scholar 

  63. Palefsky JM, Giuliano AR, Goldstone S, Moreira ED, Aranda C, Jessen H, et al. HPV vaccine against anal HPV infection and anal intraepithelial neoplasia. N Engl J Med. 2011;365(17):1576–85.

    CAS  PubMed  Google Scholar 

  64. Finlayson TJ, Le B, Smith A, Bowles K, Cribbin M, Miles I, et al. HIV risk, prevention, and testing behaviors among men who have sex with men – National HIV Behavioral Surveillance System, 21 U.S. cities, United States, 2008. MMWR Surveill Summ. 2011;60(14):1–34.

    PubMed  Google Scholar 

  65. (CDC) CfDCaP. National HIV testing day and new testing recommendations. MMWR Morb Mortal Wkly Rep. 2014;63(25):537.

    Google Scholar 

  66. Villa L, Varela JA, Otero L, Sánchez C, Junquera ML, Río JS, et al. Molluscum contagiosum: a 20-year study in a sexually transmitted infections unit. Sex Transm Dis. 2010;37(7):423–4.

    PubMed  Google Scholar 

  67. Nguyen HP, Franz E, Stiegel KR, Hsu S, Tyring SK. Treatment of molluscum contagiosum in adult, pediatric, and immunodeficient populations. J Cutan Med Surg. 2014;18(5):299–306.

    PubMed  Google Scholar 

  68. Ianhez M, Cestari SC, Enokihara MY, Seize MB. Dermoscopic patterns of molluscum contagiosum: a study of 211 lesions confirmed by histopathology. An Bras Dermatol. 2011;86(1):74–9.

    PubMed  Google Scholar 

  69. Hošnjak L, Kocjan BJ, Kušar B, Seme K, Poljak M. Rapid detection and typing of Molluscum contagiosum virus by FRET-based real-time PCR. J Virol Methods. 2013;187(2):431–4.

    PubMed  Google Scholar 

  70. Simonart T, De Maertelaer V. Curettage treatment for molluscum contagiosum: a follow-up survey study. Br J Dermatol. 2008;159(5):1144–7.

    CAS  PubMed  Google Scholar 

  71. Tyring SK. Molluscum contagiosum: the importance of early diagnosis and treatment. Am J Obstet Gynecol. 2003;189(3 Suppl):S12–6.

    PubMed  Google Scholar 

  72. Liota E, Smith KJ, Buckley R, Menon P, Skelton H. Imiquimod therapy for molluscum contagiosum. J Cutan Med Surg. 2000;4(2):76–82.

    CAS  PubMed  Google Scholar 

  73. Anderson AL, Chaney E. Pubic lice (Pthirus pubis): history, biology and treatment vs. knowledge and beliefs of US college students. Int J Environ Res Public Health. 2009;6(2):592–600.

    PubMed  PubMed Central  Google Scholar 

  74. Dholakia S, Buckler J, Jeans JP, Pillai A, Eagles N. Pubic lice: an endangered species? Sex Transm Dis. 2014;41(6):388–91.

    PubMed  Google Scholar 

  75. Gunning K, Pippitt K, Kiraly B, Sayler M. Pediculosis and scabies: treatment update. Am Fam Physician. 2012;86(6):535–41.

    PubMed  Google Scholar 

  76. Strong M, Johnstone P. Interventions for treating scabies. Cochrane Database Syst Rev. 2007;3, CD000320.

    Google Scholar 

  77. Wolf R, Davidovici B. Treatment of scabies and pediculosis: facts and controversies. Clin Dermatol. 2010;28(5):511–8.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Stanford University School of Medicine, Department of Surgery, 300 Pasteur Drive, Stanford, CA, 94305, USA

    Cindy Kin MD & Mark Lane Welton MD, MHCM

Authors
  1. Cindy Kin MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mark Lane Welton MD, MHCM
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Cindy Kin MD .

Editor information

Editors and Affiliations

  1. Division of Colorectal Surgery, University Hospitals Case Medical Center Case Western Reserve University, Cleveland, OH, USA

    Scott R. Steele

  2. Cleveland Clinic, Cleveland, OH, USA

    Tracy L. Hull

  3. Tufts University School of Medicine, Lahey Hospital & Medical Center, Burlington, MA, USA

    Thomas E. Read

  4. Ambrose and Gladys Bowyer, Loyola University, Chicago, IL, USA

    Theodore J. Saclarides

  5. University of Texas Medical Branch at Galveston, Galveston, TX, USA

    Anthony J. Senagore

  6. Ochsner Medical Center, New Orleans, LA, USA

    Charles B. Whitlow

Rights and permissions

Reprints and permissions

Copyright information

© 2016 ASCRS (American Society of Colon and Rectal Surgeons)

About this chapter

Cite this chapter

Kin, C., Welton, M.L. (2016). Sexually Transmitted Infections. In: Steele, S.R., Hull, T.L., Read, T.E., Saclarides, T.J., Senagore, A.J., Whitlow, C.B. (eds) The ASCRS Textbook of Colon and Rectal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-25970-3_19

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-25970-3_19

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-25968-0

  • Online ISBN: 978-3-319-25970-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation