{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:08:59Z","timestamp":1787314139376,"version":"build-2736575974"},"reference-count":13,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2019,4,21]],"date-time":"2019-04-21T00:00:00Z","timestamp":1555804800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Herpes simplex virus (HSV) is the leading cause of proctitis in HIV-infected individuals. However, no cases of rectal masses secondary to HSV infection have been reported to date. Herein, we present the case of a 45-year-old man with HIV infection who developed rectal pain and bleeding, along with dysuria and voiding difficulty. Colonoscopy revealed proctitis and a rectal mass with features concerning for rectal cancer. Histologic sections of the rectal mass biopsy demonstrated colorectal mucosa with viral cytopathic changes, ulceration, granulation tissue, marked inflammatory infiltrate, and fibrinopurulent exudate. Immunohistochemistry for herpes simplex virus-1 was positive in epithelial cells demonstrating a viral cytopathic effect. The patient was treated with valacyclovir for 3 weeks, which led to complete resolution of his symptoms. Follow-up sigmoidoscopy at 6 months did not show any masses. Our case illustrates the importance of considering HSV in the differential diagnosis of rectal masses. We advocate the routine use of viral immunohistochemistry for the evaluation of rectal tumors, especially in patients with clinical manifestations and endoscopic findings consistent with proctitis.<\/jats:p>","DOI":"10.3390\/diseases7020036","type":"journal-article","created":{"date-parts":[[2019,4,22]],"date-time":"2019-04-22T11:02:53Z","timestamp":1555930973000},"page":"36","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Herpes Simplex Virus Proctitis Masquerading as Rectal Cancer"],"prefix":"10.3390","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3680-1278","authenticated-orcid":false,"given":"Folusakin","family":"Ayoade","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases. Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL 33136, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2768-9712","authenticated-orcid":false,"given":"Jose Armando","family":"Gonzales Zamora","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases. Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL 33136, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youley","family":"Tjendra","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Miller School of Medicine, University of Miami, Miami, FL 33136, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,4,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Alfa-Wali, M., Muktar, S., Pissas, D., and Slater, C. (2018). Unusual case of a rectal tumour. BMJ Case Rep., 2018.","DOI":"10.1136\/bcr-2017-223944"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Serigado, J., Lewis, E., and Kim, G. (2019). Rectal bleeding caused by a syphilitic inflammatory mass. BMJ Case Rep., 12.","DOI":"10.1136\/bcr-2018-226595"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"165","DOI":"10.14309\/crj.2015.42","article-title":"Cytomegalovirus Colitis Mimicking Rectal Carcinoma in a Young Immunocompetent Patient","volume":"2","author":"Shah","year":"2015","journal-title":"ACG Case Rep. J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1001\/archinte.1986.00360170127019","article-title":"Rectal lymphoma in homosexual men","volume":"146","author":"Burkes","year":"1986","journal-title":"Arch. Intern. 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Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1056\/NEJM198603133141105","article-title":"Infections with herpes simplex viruses (1)","volume":"314","author":"Corey","year":"1986","journal-title":"N. Engl. J. Med."},{"key":"ref_9","first-page":"381","article-title":"The epidemiology of herpes simplex types 1 and 2 infection of the genital tract in Edinburgh 1978-1991","volume":"69","author":"Ross","year":"1993","journal-title":"Genitourin Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1086\/506455","article-title":"Transmission of herpes simplex virus types 1 and 2 in a prospective cohort of HIV-negative gay men: the health in men study","volume":"194","author":"Jin","year":"2006","journal-title":"J. Infect. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1056\/NEJM198304143081503","article-title":"Herpes simplex virus proctitis in homosexual men. Clinical, sigmoidoscopic, and histopathological features","volume":"308","author":"Goodell","year":"1983","journal-title":"N. Engl. J. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"424","DOI":"10.5858\/2008-132-424-AOITI","article-title":"Application of immunohistochemistry to infections","volume":"132","author":"Eyzaguirre","year":"2008","journal-title":"Arch. Pathol. Lab. 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