The British Journal of Venereal Diseases最新文献

A 27 year old homosexual man developed unusual sacral lesions during a disseminated primary herpetic attack, which was confirmed by viral culture and rising antibody titre. The lesions had a striking framboesiform appearance and healed without ulceration or scarring. Review of modern and historical published reports suggests that this may be the first illustrated description of such infection.

One hundred women with uncomplicated gonorrhoea (in five cases due to penicillinase producing strains of Neisseria gonorrhoeae (PPNG)) were treated with a single oral dose of rifampicin 900 mg and erythromycin stearate 1 g. N gonorrhoeae was reisolated from the oropharynx of one patient, who was infected with a PPNG strain, but was eradicated from the genital tract in 100% of cases. The combination eradicated Chlamydia trachomatis from only 10 (28%) of the 36 patients infected. Side effects were predominantly mild and consisted of transient nausea. The treatment merits evaluation in areas with a high incidence of PPNG strains.

The in vitro activity of the quinolone carboxylic acid, ciprofloxacin, against a variety of genital tract pathogens was examined. Each of 35 isolates of Neisseria gonorrhoeae, including some beta-lactamase producing strains and strains resistant to tetracycline, was inhibited at a concentration of 0.01 mg/l. Most (13 of 20) strains of Gardnerella vaginalis were inhibited at 1 mg/l but three isolates had minimum inhibitory concentrations (MICs) of 8 mg/l or more. Each of seven strains of Chlamydia trachomatis was completely inhibited at a concentration of 2 mg/l. Prolonged (72 hours) exposure of the chlamydiae to ciprofloxacin was required for inhibition at this concentration.

Contact tracing has always been a vital element in the control of sexually transmitted disease (STD), and the early full time contact tracers were more effective than doctors in this work. Those appointed to the early posts had to train themselves and they concentrated on contact tracing. Training has now improved, and most contact tracers in Britain, now called Health Advisers in STD, have attended a full time five day residential training course, and it is hoped that better courses may be developed. A handbook has been produced and widely circulated. The Society of Health Advisers in STD holds regular regional meetings and an annual conference. Health advisers may discover personal problems and have an important role in education, both of which activities are covered in their role specification. Health advisers in STD have developed from contact tracers to undertake a broad range of functions, but the question is asked whether they could contribute to other aspects of health care within the clinic.

We report a case of early syphilis with multiple bone lesions which all resolved after treatment with penicillin. We discuss why bone lesions may be more prevalent than generally believed and why 99m-Tc-MDP-bone scintigraphy is more sensitive than radiography in detecting syphilitic periostitis.

We describe the development of the Australian gonococcal surveillance programme from February 1979 to July 1982. Participants in the programme were the major public health laboratories in each state, which perform quantitative sensitivity tests on about 5400 strains of Neisseria gonorrhoeae yearly. Participating laboratories conducted sensitivity tests by a standardised technique which is described, and the results from each centre were collated quarterly. Temporal and regional differences in gonococcal sensitivity patterns were noted and, in the twelve months ending June 1982, there was a trend towards a decrease in gonococci sensitive to penicillin. Increasing numbers of penicillinase producing gonococci were found, and the isolation rates of these strains varied in different regions at different times.

The recent emergence of spectinomycin resistant penicillinase producing Neisseria gonorrhoeae (PPNG) and the high prevalence of PPNG strains among the gonococcal isolates in Seoul represent a grave challenge to the programme for controlling sexually transmitted disease (STD). Fifty men with uncomplicated gonococcal urethritis caused by PPNG strains were treated with a single intramuscular injection of 1 g cefoperazone. Forty two patients were followed up. All patients recovered including three who became reinfected and required further treatment. Two patients (4.8%) developed postgonococcal urethritis (PGU). The MIC90 of cefoperazone measured by an agar dilution susceptibility test was 0.12 mg/l.