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All patients presenting with new rectal symptoms and deemed high-risk for monkeypox should be isolated and screened for the disease, and appropriate personal protective equipment should be worn by healthcare professionals caring for them. Clinicians should have a low threshold for cross-sectional imaging in patients with confirmed or suspected monkeypox who experience persistent and severe rectal symptoms or who become systemically unwell to investigate for complications such as perforation and abscess formation. The vast majority of monkeypox cases do not require antibiotics and their use should be reserved for patients who show signs of secondary bacterial infection or sepsis.<\/jats:p>","DOI":"10.1136\/bcr-2022-252168","type":"journal-article","created":{"date-parts":[[2023,1,18]],"date-time":"2023-01-18T04:30:14Z","timestamp":1674016214000},"page":"e252168","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Monkeypox-associated proctitis and rectal wall perforation"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9896-8682","authenticated-orcid":false,"given":"Lottie","family":"Brown","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery, Guy\u2019s and St Thomas\u2019 Hospitals NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Delaney","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Guy\u2019s and St Thomas\u2019 Hospitals NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Hainsworth","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Guy\u2019s and St Thomas\u2019 Hospitals NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,1,17]]},"reference":[{"key":"2025082712291387000_16.1.e252168.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(03)00856-9"},{"key":"2025082712291387000_16.1.e252168.2","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0010141","article-title":"The changing epidemiology of human monkeypox-A potential threat? 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