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Abscess or something worse?
  1. Khalid Hamid Changal1,
  2. Richard Van De Graaf2
  1. 1 Internal Medicine, St. Vincent’s Mercy Medical Center, Toledo, Ohio, USA
  2. 2 General Surgery, St. Luke’s University Hospital, Bethlehem, Pennsylvania, USA
  1. Correspondence to Dr Khalid Hamid Changal, Internal Medicine, St. Vincent’s Mercy Medical Center, Toledo, OH 43608, USA; khalidchangal{at}

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A 25-year-old homosexual man, not regular with treatment, presented with fever, rectal pain and intermittent haematochezia. He had been diagnosed with HIV/AIDS 1 year prior. Examination showed anal condylomas and non-tender inguinal lymphadenopathy. CD4 count was 74/µL. CT scan of abdomen and pelvis showed a small hypodense collection with peripheral enhancement in the left perirectal region, measuring 1.9×1.4×2.5 cm (figure 1A). A diagnosis of rectal abscess was made. Treatment was done with intravenous antibiotics. Patient’s symptoms improved after 7 days of treatment. Two months …

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