Indian Journal of Sexually Transmitted Diseases and AIDS最新文献

Uveitis in syphilis was reported often though it is not common. It can occur both in early and late syphilis. Syphilis transmission through anal contact and heterosexual contact is common. Transmission through oral sex in the absence of extragenital lesions is extremely rare. If not diagnosed earlier, uveitis can damage the vision permanently. The eyes will not see what the mind does not know. Hence, this case was reported to alert the young physicians to recognize this condition earlier. A high index of suspicion is essential to arrive at the diagnosis of this condition. Ocular syphilis and late syphilitic manifestations are quite rare nowadays. Once again, a resurge in syphilis cases was observed widely all over the globe and also in India. At this juncture, it will not be a surprise to have once again a rising incidence of cerebral venous system and central nervous system syphilis. Young physicians would not have a chance to come across a case of a case of ophthalmic syphilis. The report of such cases will alert them and make them suspect and diagnose cases of ocular syphilis earlier so that we can overcome the chances of preventable blindness with effective treatment.

In this case report, we present a 35-year-old homosexual man with advanced HIV disease and disseminated tuberculosis (TB) who developed paradoxical TB immune reconstitution inflammatory syndrome (IRIS). Corticosteroids, vital in life-threatening IRIS, were initiated, resulting in symptom resolution but unmasking AIDS-associated Kaposi's sarcoma (KS). Diagnostic confirmation revealed disseminated KS, necessitating a comprehensive therapeutic strategy involving chemotherapy and thalidomide as a steroid-sparing agent. This case underscores the complexity of managing advanced HIV disease with IRIS, emphasizing the cautious use of corticosteroids due to the potential risk of KS unmasking. The report contributes to the limited documentation of indigenous HIV-associated KS cases in India and highlights the need for vigilant monitoring and careful therapeutic decisions in this population.

A young male with no known addictions and comorbidities presenting with recurrent clonic-myoclonic movements, initially localized to the left corner of the mouth and left upper limb, evolving into epilepsia partialis continua, despite appropriate sequential antiepileptic medications, subsequently progressed to refractory status epilepticus. He was tested positive for HIV infection and his neuroimaging revealed nonenhancing lesions, a novel finding in HIV-related encephalitis. We managed him with intravenous immunoglobulin along with multiple antiepileptic medications and highly active antiretroviral therapy (ART), and he exhibited a rapid clinical recovery over 3 weeks. This case highlights the importance of initiating immunomodulatory therapy promptly at presentation and underscores the challenges of managing drug interactions between antiepileptic drugs and antiretroviral therapy (ART), emphasizing the need for careful selection of medications in HIV-infected individuals.

Alopecia is usually an overlooked manifestation of syphilis commonly seen in secondary syphilis with a prevalence of 2.9%-7%. It is broadly classified into symptomatic and essential alopecia and the observed patterns include moth-eaten type, generalized thinning, and mixed pattern. Here, we report a 38-year-old male who presented with mixed pattern alopecia of the scalp and bilateral postauricular lymphadenopathy. Toluidine red unheated serum test and Treponema pallidum hemagglutination were positive in a titer of 1:128 and 1:720, respectively. Trichoscopy showed empty follicles, perifollicular and interfollicular scales, faint reddish-brown pigmentation, black dots, and broken and regrowing hairs. The patient was treated with a single dose of benzathine penicillin 2.4 million IU intramuscular injection. The patient was regularly followed up and showed marked regrowth of hairs and resolution of postauricular lymphadenopathy. Lymph node and hair examination and trichoscopy as a noninvasive tool could aid in the diagnosis of alopecia syphilitica.

Pemphigus vulgaris is a rare autoimmune blistering disorder which can occur with other disorder with autoimmune etiology like lichen planus pigmentosus. The concurrence of pemphigus vulgaris and HIV infection has been rarely reported in literature. Here we report a 31 year old patient who came with oral and skin erosions suggestive of pemphigus vulgaris and later developed HIV infection with lichen planus pigmentosus.