A patient with rectal pain, purulent discharge, and a history of high-risk sexual activity is likely suffering from?

The presentation of rectal pain, purulent discharge, and a history of high-risk sexual activity strongly suggests proctitis. Proctitis is the inflammation of the rectum, which can be caused by various infectious agents, particularly sexually transmitted infections (STIs) such as gonorrhea, chlamydia, and herpes simplex virus. These infections frequently lead to symptoms like pain and discharge, making proctitis a likely diagnosis in this scenario.

In high-risk sexual behavior, the exposure to STIs is increased, further supporting the possibility of proctitis as the underlying condition. Purulent discharge specifically points toward an infectious process, particularly an STI, which can exacerbate rectal inflammation.

Other conditions like anal fissures, hemorrhoids, and rectal abscesses can cause rectal pain but typically present with distinct characteristics. Anal fissures are usually associated with sharp pain during bowel movements and may not present with purulent discharge. Hemorrhoids can cause bleeding and discomfort but are more associated with a history of straining or constipation rather than sexual activity; they also do not present with purulent discharge. Rectal abscesses can cause significant pain and possibly discharge as well, but they are usually associated with a fluctuant mass and