Cytomegalovirus (CMV) infections, while typically associated with immunocompromised states, can present in immunocompetent individuals with specific risk factors, such as recent high-risk sexual activity [1,2]. This case report highlights the clinical course, diagnostic challenges, and therapeutic management of a 37-year-old Caucasian male who developed Disseminated CMV (hepatitis and proctitis) following a first sexual encounter. The patient initially presented with symptoms suggestive of rectal gonorrhoea, which persisted despite treatment, leading to a broader diagnostic investigation revealing CMV as the underlying pathogen [3]. CMV proctitis is a rare manifestation characterized by mucosal inflammation and ulceration in the rectum, often mimicking other inflammatory conditions or sexually transmitted infections (STIs) [4]. The differential diagnosis can be challenging, necessitating comprehensive evaluation including CMV-specific testing and endoscopic examination. Prompt recognition and targeted therapy with antiviral agents like ganciclovir are crucial in achieving clinical resolution and preventing complications associated with CMV infection [5].

This report underscores the importance of considering CMV as a potential etiology in patients presenting with persistent or worsening rectal symptoms, especially in the context of recent STI treatment. By elucidating the diagnostic process and therapeutic outcomes in this case, we aim to contribute to the understanding of CMV-associated proctitis and advocate for heightened vigilance in similar clinical scenarios [6]