| Gonorrhea1,3 | Can cause infection of any mucosal membrane, including the genital tract, pharynx, and rectum Urethritis may be asymptomatic but usually presents with dysuria and purulent discharge Pharynx may serve as a reservoir and is typically asymptomatic; only rarely causes pharyngitis Rectal infections may be asymptomatic but can cause localized inflammation with tenesmus and rectal discomfort and discharge; scant bleeding is possible Incubation period: 2-7 d (range: 1-14 d) Transmission: direct contact with infectious exudate
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| Chlamydia1,3 | Can cause infection of any mucosal membrane, including the genital tract, pharynx, or rectum Urethritis may be asymptomatic but usually presents with dysuria and clear mucoid discharge The pharynx may serve as a reservoir and is almost always asymptomatic Rectal infections are often asymptomatic but can cause localized inflammation with rectal discomfort and discharge The L serovar (lymphogranuloma venereum) can cause pronounced rectal symptoms including pain, tenesmus, bleeding and marked discharge; lower abdominal and low back pain from inflamed pelvic lymph nodes may also occur Incubation period: 5-14 d (range: 1-6 wk) Transmission: direct contact with infectious exudate
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| Syphilis1,3 | Initially causes a chancre (a shallow, indurated, typically painless ulcer); chancres can have surrounding edema; pain is possible Chancres occur at the site of sexual contact and inoculation: penis, scrotum, lips, oral cavity, perianal region, or rectum Rectal chancres would be difficult to see but could correspond with scant rectal bleeding and tenesmus Incubation period: 3 wk (range: 3-90 d) Transmission: direct contact with infectious lesions
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| Herpes simplex virus1,3 | Causes painful localized vesicles that rupture, leaving markedly tender ulcers with surrounding erythema and possible edema First-episode herpes simplex outbreaks can cause fever Typically occurs on the penis, scrotum, upper thighs, and perianal region Rectal lesions will be difficult to see but can cause tenesmus, bleeding, and diarrhea Incubation period: 6-8 d (range: 1-26 d) Transmission: direct contact with infectious lesions
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| HIV1,3,4 | Acute HIV infection often causes mononucleosis-like symptoms Seroconversion symptoms can include fever, chills, swollen lymph nodes, abdominal pain, sore throat, diarrhea, and rash Incubation period: 2-6 wk Transmission: direct contact with infectious bodily fluids
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| Mpox5 | Symptoms can range from localized clusters of to diffusely distributed ulcerated indurated lesions, which can be painful Rectal mpox lesions can cause rectal pain, discharge, and bleeding; fevers are common with mpox infection, as is lymphadenopathy Incubation period: 3-21 d Transmission: direct contact with infectious lesions, mucosal surfaces, or fomites
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| Shigellosis (enteric infection)6,7 | Causes infection within the rectosigmoid colon, causing fever, abdominal cramps, and bloody mucoid diarrhea Incubation period: 2 d (range: 1-7 d) Transmission: oral-anal and oral-perineal contact
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| Escherichia coli, campylobacteriosis, salmonellosis, or yersiniosis (enteric infections)7,8 | Clinically indistinguishable infections causing varying degrees of abdominal pain, diarrhea (with or without blood or mucus), and possible fever Incubation periods: range from 1-7 d Transmission: oral-anal and oral-perineal contact
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| Cryptosporidiosis, cyclosporiasis, or giardiasis (protozoan infections)7,8 | Diarrhea, anorexia, abdominal cramps, bloating, and malaise Incubation period: 7-14 d Transmission: oral-anal and oral-perineal contact
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