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Gonococcal perianal abscess: re-emergence after cessation of co-trimoxazole

We report a case of perianal abscess due to Neisseria gonorrhoeae , which appears to have been suppressed but not eradicated by chronic low dose co-trimoxazole for a period of almost 6 months between acquisition and diagnosis.

The patient was a 34 year old HIV infected homosexual man treated with didanosine, stavudine, and nevirapine with a HIV viral load of 500 copies per ml and a CD4 lymphocyte count of 280 × 106/l. He was taking co-trimoxazole 400 mg/80 mg once daily to prevent Pneumocystis carinii pneumonia (PCP).

He reported last …