A 30-year-old cisgender man who has sex with cisgender men presents with a 1-week onset of anorectal pain, constipation, and a malodorous, purulent rectal discharge. He denies fever, chills, diarrhea, hematochezia, and other systemic symptoms. He reports having receptive anal intercourse with three different partners during the last four weeks and has inconsistently used condoms.