USMLE Case #7 A 33 y/o practicing proctologist arrives at your office and appears in emotional and physical distress. His chief complaint is new onset bloody diarrhea with abdominal pain and fever for the past three days. He has never had these symptoms before and has not had any recent changes in his dietary habits. Upon questioning, he reluctantly reveals that he participates in receptive anal intercourse with other men. The patient has also noted joint pains associated with morning stiffness that lasts for fewer than fifteen minutes. Careful physical examination demonstrates a small opening next to the anal orifice that is actively draining foul smelling fluid. Which of the following is the most likely diagnosis? A) Celiac sprue B) Acute HIV seroconversion C) Gay bowel syndrome D) Crohn's Disease E) Ulcerative Colitis F) Munchausen syndrome
