Approach to perianal problems Quiz: Ace Your Exams
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A 26-year-old man presents to the emergency department with anal discharge. He states that about two months ago, he had a painful bump near his anus that expressed fluid and then went away within a week. However, two days ago, he noticed that he had brown discharge in his underwear, and his perianal region has been itching. He does not have fevers, chills, or pain in the perianal region. Temperature is 37.0 °C (98.6 °F), pulse is 65/min, blood pressure is 122/85 mmHg, and SpO2 is 100% on room air. Examination reveals no evidence of an abscess but shows an external opening on the left lateral surface of the peri-anal region. Slight pressure expresses scant brown discharge. Anoscopy does not show an internal opening. What is the most appropriate next step in the management of this patient?
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