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Painful proctitis associated with anorectal mpox, syphilis, HSV, LGV, gonorrhoea and Mycoplasma genitalium in a person living with virologically suppressed HIV and vaccinated against mpox
  1. Zoe Y Huang1,
  2. Vincent J Cornelisse1,2,3,
  3. Rachel M Burdon1
  1. 1 Department of Sexual Health Medicine, Sydney Local Health District, Sydney, NSW, Australia
  2. 2 Kirby Institute, University of New South Wales, Sydney, NSW, Australia
  3. 3 Central Clinical School, Monash University, Melbourne, VIC, Australia
  1. Correspondence to Dr Zoe Y Huang, Department of Sexual Health Medicine, Sydney Local Health District, Sydney, NSW 2050, Australia; zoe.huang{at}


A gay man with well-controlled HIV and vaccinated against mpox presented with severe proctitis. Testing revealed anorectal mpox, herpes simplex virus, lymphogranuloma venereum, Neisseria gonorrhoeae and Mycoplasma genitalium. Serology was indicative of infectious syphilis. This case highlights the need to consider a wide range of concurrent sexually transmitted infections in patients with proctitis, including those vaccinated against mpox.

  • HIV

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  • Handling editor Anna Maria Geretti

  • Twitter @DrVinCornelisse

  • Presented at An abstract of this case report has been presented as an electronic poster at the European AIDS Conference 2023 in Warsaw, Poland, 18–21 October 2023.

  • Contributors ZYH, VJC, and RMB provided clinical care to the case patient. ZYH researched and drafted the initial manuscript, and jointly edited the manuscript. VJC and RMB jointly reviewed and edited the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.