Case Presentation: A 31-year-old man with past medical history of secondary syphilis and HIV/AIDS (CD4 47) intermittently on ART presented with worsening rectal pain and recurrent rectal abscesses. He endorsed rectal pruritis, nausea, weight loss, and lower extremity pain. He denied fevers, night sweats, abdominal pain, or diarrhea. Last year, he had a prior rectal [...]