Question: We describe a 47-year-old man who has sex with men and is infected with the human immunodeficiency virus, which was diagnosed 6 years ago. He was also a hepatitis B carrier and has a history of gout. He had mucus passage during defecation for 1 month, and then bloody material passage was also noted for 2 weeks. Tenesmus and rectal palpable lesion were also reported. In addition, he had engaged in sexual behavior with a man few days before symptoms presented.