Indian Journal of Sexually Transmitted Diseases and AIDS最新文献

Background: Genital mycoplasmas are emerging sexually transmitted pathogens implicated in genitourinary infections, with their incidence increasing in recent years. They frequently cause asymptomatic, recurrent, and chronic infections, leading to pelvic inflammatory disease and infertility, thus posing a significant public health challenge.

Aim: The study aimed to determine the prevalence of Ureaplasma urealyticum, Mycoplasma hominis, and Mycoplasma genitalium among patients presenting with genital tract infections in a tertiary care hospital in South India.

Materials and methods: This prospective observational study was conducted from June 2022 to June 2024 in the department of dermatovenereology and leprology. Sexually active males and females (≥18 years) with genital discharge, dysuria, and lower abdominal pain were enrolled in the study. Vaginal, endocervical, and urethral discharge samples were subjected to preliminary microscopic examination (10% potassium hydroxide, Gram stain, and wet mount) and polymerase chain reaction for U. urealyticum, M. hominis, and M. genitalium.

Results: Among 79 patients (10 males and 69 females), the overall prevalence of genital mycoplasmas was 43% (34/79). U. urealyticum was detected in 40.5% (32/79), while M. hominis was found in 6.3% (5/79). Coinfection with U. urealyticum and M. hominis was noted in 3.8% (3/79). No cases of M. genitalium were detected. Among U. urealyticum cases, 28.1% had candidiasis, 9.3% had bacterial vaginosis, and 6.2% had gonorrhea coinfections. M. hominis was associated with gonorrhea in 20% of cases.

Conclusion: In our study, genital mycoplasmas were detected in 43% of patients presenting with genital symptoms. This high prevalence highlights their clinical relevance and underscores the need for targeted PCR-based screening in sexually transmitted infection clinics, considering their frequent underdiagnosis.

Context: Vulval pruritus is a chronic, debilitating symptom frequently associated with various dermatological conditions. It significantly impacts quality of life, sexual function, sleep, and psychological well-being. The etiology varies by age due to factors such as estrogen levels, skin barrier function, and environmental factors.

Aims: This study aims to assess the vulval pruritus clinical pattern across different age groups and identify major etiological factors.

Settings and design: A cross-sectional study was conducted over 18 months at a tertiary care center which included 70 adult women with vulval pruritus.

Materials and methods: Data were collected through clinical history, physical examination, and laboratory investigations.

Statistical analysis used: Statistical analysis was performed using Stata software to determine the prevalence, associated factors, and clinical characteristics.

Results: The mean age was 42.5 years. The highest prevalence was observed in the reproductive age group (40%), followed by postmenopausal (28.6%), perimenopausal (24.3%), and menopausal (7.1%) groups. Infective causes were identified in 69% of cases, with vulvovaginal candidiasis (VVC) (27.1%) being the most common. Noninfective causes accounted for 31% of cases, including conditions such as lichen simplex chronicus (LSC).

Conclusions: Infectious causes, especially VVC and candidal intertrigo, are the predominant aetiologies of vulval pruritus in women across various age groups, followed by, dermatophytosis, genital warts, herpes genitalis, and chancroid. Noninfective causes include LSC, and lichen sclerosus also play a significant role, varying by age and hormonal status. A comprehensive clinical evaluation, with an assessment of sexual history, hygiene practices, and comorbidities, is essential for accurate diagnosis and effective management.

Erosive lichen planus (LP) of the genitalia is a rare and often underdiagnosed variant of LP. It can present with painful erosions. We report a case of a 55-year-old diabetic male presenting with an isolated chronic painful ulcer over the glans penis with no other mucocutaneous features. Investigations done for screening of sexually transmitted infections were negative. Clinical suspicion and dermoscopy of the lesion guided the further line of management, and histopathology confirmed the diagnosis of LP. The patient responded well to topical corticosteroids and oral antihistamines. Thus, suspicion of inflammatory genital dermatoses should be kept in mind for appropriate management.

Syphilis is a sexually transmitted multisystem disease caused by Treponema pallidum. Although easily treatable in early stages, if unrecognized, the disease usually progresses through its natural stages (i.e., primary, secondary, early latent, late latent, and tertiary) with devastating neurological, cardiovascular, and ocular sequelae. Syphilitic eye involvement may occur in any stage of the disease, affects mainly the posterior segment of the eye, and may cause blindness. Syphilitic eye involvement is especially severe in patients co-infected with human immunodeficiency virus. Ocular syphilis is managed by aqueous crystalline penicillin infusions for 10-14 days.

Background: Sexually transmitted infections (STIs) remain a significant public health concern, with increasing trends observed globally.

Aims and objectives: This study aimed to analyze the prevalence and trends of STIs at a tertiary care center in east India over a two-year period.

Materials and methods: This cross-sectional study was conducted at a tertiary care center in east India from 2022 to 2024. A total of 11,803 patients were included.

Results: The male-to-female ratio was 1.13:1. The majority of cases were in the age group of 18-30 years (60.8%), and high-risk behaviors, including multiple sexual partners and substance abuse, were prevalent. The findings indicate a rising trend in genital ulcer disease due to herpes, secondary syphilis, and HIV-positive cases. Men who have sex with men with anal warts and individuals with a history of multiple exposures also showed increasing numbers.

Conclusion: The results highlight the urgent need for enhanced STI surveillance, awareness programs, and targeted interventions to curb infection rates. Strengthening routine screening, expanding access to treatment, and implementing strategic public health initiatives are critical in addressing the rising burden of STIs.

Introduction: Syphilis, is a great imitator and presents with a wide range of mucocutaneous and systemic manifestations, which can mimic many diseases. Few studies in India have shown a rise in the prevalence of syphilis which is also shown by Western studies. In view of its latency and myriad presentations, and easy availability of broad-spectrum antibiotics it is being underdiagnosed. This retrospective study aims to evaluate the current trend in the epidemiology of acquired syphilis and other STIs.

Materials and methods: Retrospective analysis of all the cases of acquired syphilis registered in INHS Asvini hospital from 2017 to 2022 was done. Complete epidemiological, clinical, and investigational data were recorded and assessed.

Results: Total of 261 cases of STI who presented at our hospital, 28 (10.7%) cases were diagnosed as syphilis. There were 24 (85.7%) males and 4 (14.3%), females. Primary syphilis was diagnosed in 7 (20%), secondary in 10 (35.71%), and latent in 11 (39.28%) cases. Two patients were serologically positive for HIV. Out of the total 261 patients, genital warts was the most common STI diagnosed followed by genital herpes, molluscum contagiosum, urethritis and syphilis.

Conclusion: The epidemiological trend is on the rise for syphilis. The number of cases of primary syphilis diminished significantly, with a concomitant rise in secondary and early latent syphilis. Rise in latent disease points toward either lack of accurate diagnosis or inadequate treatment. Primary stage of the disease is alarming to the patient on account of its site and presents more commonly than the secondary or latent stage. Dermatologists should exercise a high suspicion of syphilis in all asymptomatic eruptions.

The intersection of human immunodeficiency virus (HIV) and Mycobacterium leprae infection creates unique diagnostic and therapeutic challenges. The roll-out of antiretroviral therapy (ART) has revealed leprosy-associated immune reconstitution inflammatory syndrome (L-IRIS), marked by paradoxical clinical worsening as immune function recovers. This review explores the clinical profiles, immunological mechanisms, and treatment outcomes of L-IRIS and leprosy reactivation in people living with HIV. Scoping review, preferred reporting items for systematic reviews and meta-analyses extension for Scoping review, systematic search: We searched PubMed, Scopus, Embase, Web of Science, LILACS(Latin America and the Caribbean Literature on Health Sciences), and Cochrane Library for original case reports, case series, and cohort studies documenting HIV-leprosy coinfection and IRIS. Data were extracted across six domains: epidemiology, clinical manifestations, histopathology, immunology, therapy, and evidence gaps. Geographic clustering, immunodeficiency, reversal reactions: Eighteen studies were included, predominantly from Brazil, India, and French Guiana. Borderline tuberculoid (BT) leprosy was the commonest clinical form; type 1 reactions (T1R) were the most frequent immune events, usually 2-6 months after ART initiation. Most patients had advanced immunosuppression (CD4+ <100/μL), with clinical IRIS coinciding with immune recovery. Histopathology revealed granulomatous inflammation and CD68+ macrophage infiltration. Standard treatment included World Health Organization-recommended multidrug therapy (MDT) and corticosteroids, yielding generally favorable outcomes; however, there was a lack of consensus on IRIS management, long-term follow-up, and no validated biomarkers for L-IRIS, which remains under-recognized, with significant diversity in presentation and limited standardized diagnostic criteria. Improvement in care requires biomarker validation, consistent outcome tracking, and the creation of context-adapted management pathways. Expanded integrated surveillance and patient-centered research in endemic areas are essential to reduce the dual disease burden.