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A 26-year-old man who has sex with men presented with hematochezia and increased bowel movement frequency. Colonoscopy revealed a large deep rectal ulcer with mucopurulent exudate, and pelvic magnetic resonance imaging showed rectal wall thickening with regional lymphadenopathy, raising concern for rectal cancer. Histopathology showed inflammatory changes without malignancy. Rectal secretion testing was positive for Chlamydia trachomatis RNA, and the patient was clinically diagnosed with probable anorectal LGV. Oral doxycycline 100\u00a0mg twice daily for 21\u00a0days led to marked ulcer regression at 3\u00a0weeks and near-complete mucosal healing by 6\u00a0weeks. This case highlights the importance of considering sexually transmitted proctitis in young men who have sex with men patients with atypical rectal ulcers.<\/jats:p>","DOI":"10.1093\/jscr\/rjag899","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T11:43:35Z","timestamp":1790077415000},"source":"Crossref","is-referenced-by-count":0,"title":["Lymphogranuloma venereum presenting as a giant rectal ulcer with inguinal lymphadenitis: a case report"],"prefix":"10.1093","volume":"2026","author":[{"given":"Yidian","family":"Lei","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery, The Hangzhou Third People\u2019s Hospital , No. 38 Westlake Avenue, Hangzhou City, Zhejiang Province 310009 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiufeng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, The Hangzhou Third People\u2019s Hospital , No. 38 Westlake 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