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January 16, 1981

Evaluation of Acute Proctitis

Author Affiliations

Allentown Hospital Allentown, Pa

JAMA. 1981;245(3):235-236. doi:10.1001/jama.1981.03310280015015

To the Editor.—  Richard R. Babb, MD (1980;244:358), recently presented guidelines for the clinician to use in ascertaining the cause of acute proctitis, including stool analysis for infectious agents. We would like to draw attention to a more recently recognized and important cause of proctitis caused by Campylobacter fetus subspecies jejuni (1979;242:2519).1 Stool samples collected during sigmoidoscopy should be delivered immediately to the microbiology laboratory where they may be examined by either darkfield or phase contrast microscopy for typical darting or corkscrew-like motility. For definitive diagnosis, comprehensive bacteriologic studies should include culturing on Campylobacter selective medium3 incubated at 42 °C under microaerophilic conditions. Since epidemiologic studies have confirmed acquisition of disease from contaminated food, water, animals, eg, dogs with diarrhea, and slaughterhouses, patients should be questioned about these possible contacts.Severe campylobacteriosis may be clinically and histologically indistinguishable from ulcerative colitis as well as other enteric infections. Only