The British Journal of Venereal Diseases最新文献

Exposure of monolayer cultures of human urogenital and vaginal (HeLa), human epithelial (HEp-2), normal baboon testicular (NBT), and monkey kidney (Vero) cells to live pathogenic Trichomonas vaginalis resulted in extensive disruption of monolayers. Trypan blue was taken up by all host cells released from cell monolayers, which indicated irreversible damage of these cell types by trichomonads. Time and dose related data on cytotoxicity kinetics were obtained using increasing ratios of parasites to cells. All cell types were most sensitive to trichomonads at a multiplicity of infection of one. Release of tritiated thymidine (3H-thymidine) of the deoxyribonucleic acid (DNA) of prelabelled host cells after incubation with T vaginalis corroborated that extensive cytotoxicity was caused by pathogenic trichomonads in man. Only living parasites were cytotoxic, and no trichomonal toxic products were implicated in disruption of the cell monolayer cultures. A pathogenic bovine trichomonad, Tritrichomonas foetus KV-1, produced half as much cell damage as did T vaginalis. Trichomonas tenax, a non-pathogenic member of the normal flora of the oral cavity in man, produced no measurable cytotoxicity to HeLa cells when compared with the pathogenic human trichomonads.

We report four cases of rectal spirochaetosis, one in an active male homosexual. One of the heterosexual patients was referred to the genitourinary clinic by a general surgeon after spirochaetes had been found on histopathological examination of a rectal biopsy specimen. We doubt that most of our cases represent sexual transmission of spirochaetosis, or that the condition causes disease in most people. Rectal spirochaetosis possibly occurs only when the normal flora of the gut are disturbed for other reasons. Most of our patients became asymptomatic after nonspecific treatment, although metronidazole appears to be specific.

Each of 201 men with symptoms and signs of acute urethritis was randomly assigned to one of two treatment regimens: ampicillin (2g) plus probenecid (1g), or sulphamethoxazole-trimethoprim (SMX-TMP) (sulphamethoxazole 1600 mg plus trimethoprim 320 mg) four tablets twice daily for two days. Before treatment Neisseria gonorrhoeae was isolated from 162 patients, while coexistent Chlamydia trachomatis was recovered from 42 (26%) men. After treatment N gonorrhoeae persisted in 11 (14.3%) of the 77 patients treated with ampicillin and probenecid and in three (3.5%) of the 85 treated with SMX-TMP (p less than 0.05), while C trachomatis persisted in four (16%) of the 25 men treated with SMX-TMP and in all 17 patients treated with ampicillin and probenecid. SMX-TMP was thus more effective than ampicillin in treating acute gonorrhoea in men and in eradicating concurrent C trachomatis infection.

We compared the survival of a laboratory strain of Chlamydia trachomatis serovar L-2 in different media and at different temperatures (room temperature, 4 degrees C, and -70 degrees C). At these temperatures the best storage medium was 2SP (0.2 mol/l sucrose in 0.02 mol/l phosphate buffer supplemented with 10% fetal calf serum). We used material obtained from patients to study the sensitivity of the culture method as a function of sample storage time and temperature. Compared with results on direct inoculation, material stored in 2SP for 48 hours gave 11% fewer positive cultures at 4 degrees C and 14% fewer at room temperature. Of samples which gave negative results on direct inoculation, 4% were positive after storage at 4 degrees C for 48 hours and 2% after storage at -70 degrees C for a week. As expected, the number of inclusion forming units in the original material proved to be important for the percentage of positive cultures among the stored samples.

A 24 year old woman with Crohn's disease presented initially with a severe primary genital herpes infection. After the first attack frequent recurrences occurred on the hands, feet, and genitalia. The patient was treated with oral acyclovir for 12 weeks, during which time she had two brief minor recurrences. After treatment was stopped lesions recurred at the same sites.

Hepatic structure and function of 22 unselected patients with early syphilis was assessed. In 20 (91%) routine hepatic tests or bromsulphalein retention showed mild non-specific abnormalities. Minor changes in hepatic structure were present in 12 (55%), in three of whom intrahepatic spirochaetes were found. The only patient who had hepatomegaly also had splenomegaly. Observed changes in hepatic structure correlated with neither physical signs nor results of biochemical tests. Hepatic changes in early syphilis are common but frequently subclinical.

In a study of 121 men with uncomplicated gonococcal urethritis, 64 were treated orally with a single dose of 3 g amoxycillin and 250 mg of the specific beta-lactamase inhibitor, clavulanic acid, and 57 with a single intramuscular injection of 2.4 MU procaine penicillin. After seven days, six (9.4%) patients treated with amoxycillin and clavulanic acid were still culture positive for Neisseria gonorrhoeae, compared with 26.3% of those treated with procaine penicillin.

We describe a case of urethritis caused by group B streptococci. The diagnosis was confirmed by examination of a Gram stained smear, isolation of the organism from the urethral discharge, and also by the clinical response to treatment with phenoxymethyl penicillin.