Indian Journal of Sexually Transmitted Diseases and AIDS最新文献

Opportunistic infections in patients with human immunodeficiency virus (HIV) can mimic each other, complicating diagnosis. Here, we report a rare case of disseminated Talaromyces marneffei in a 39-year-old immunocompromised male with HIV and pulmonary tuberculosis. The patient had respiratory symptoms, systemic manifestations, and skin lesions. Clinical and pathological investigations suggested disseminated histoplasmosis; however, microbiological culture confirmed the diagnosis of disseminated talaromycosis. Imaging confirmed central nervous system involvement. Treatment with amphotericin B led to significant initial clinical improvement; however, eventually the patient succumbed to his illness. This case highlights the importance of maintaining a high level of clinical suspicion and early detection, especially in endemic regions. Awareness among clinicians can improve outcomes in immunocompromised individuals by ensuring timely antifungal therapy.

We report the case of a 29-year-old HIV-positive male on antiretroviral therapy who presented with multiple pinhead-sized papules that progressed into varying-sized ulcers over the penile shaft and glans penis. The patient had a history of both protected and unprotected sexual encounters. Recent contact tracing led to the treatment of some partners, although several could not be traced due to residing in distant areas. The patient had a history of recurrent herpes genitalis for the past 4-5 years, with frequent outbreaks. Laboratory findings revealed a CD4 count of 677 cells/mm³ and the patient tested negative for hepatitis B, hepatitis C, VDRL, and TPHA. Diagnosis of donovanosis was confirmed by Giemsa staining, which revealed Donovan bodies. This case highlights the importance of early diagnosis, partner tracing, and comprehensive treatment strategies in managing donovanosis in HIV-positive individuals.

Syphilis, often referred to as "the great imitator," frequently leads to misdiagnosis due to its diverse clinical manifestations. It typically presents with macular, maculopapular, or papular lesions, and can, although rarely, cause erythema multiforme (EM)-like lesions. We report a case of secondary syphilis in a patient living with HIV/AIDS, presenting with EM-like lesions, showing numerous plasma cells on histopathological examination. Dermoscopy of these lesions revealed a diffuse red background with central purpuric areas and dotted vessels at the periphery. These lesions resolved with treatment for secondary syphilis. This case is notable due to the rarity of EM-like lesions in secondary syphilis, highlighting the importance of early diagnosis and treatment.

Introduction: Human immunodeficiency virus (HIV) was first discovered in 1983 and has since claimed around 40.4 million lives globally as of 2022. This alarming figure highlights the potential for HIV to escalate into a severe global health crisis if not properly managed. The virus is linked to various mucocutaneous manifestations, which can serve as early indicators of HIV infection and provide prognostic insights into disease progression. These conditions can significantly impact the quality of life and, in severe cases, may even be life-threatening.

Aims and objectives: This study was done to understand the clinico-epidemiological profile of mucocutaneous manifestations in HIV patients attending Dermatology, Venereology, and Leprosy (DVL) Outpatient Department (OPD) and to analyze the demography, risk factors, CD4 counts, and their correlation with different mucocutaneous manifestations.

Materials and methods: The present study is a retrospective observational study conducted in HIV-positive patients who attended the OPD of the DVL Department of Government General Hospital, Khammam, for a period of 3 years, i.e., from January 2021 to December 2024. Patient records were retrieved electronically from the database. Clinical and demographic data were collected and laboratory investigations wherever necessary were done.

Results: Out of a total of 8216 patients who attended the DVL OPD during this period, 2017 (2.3%) were tested positive for HIV. Of these, 1755 (87.01%) patients had mucocutaneous manifestations, in which 1056 patients (60%) had infectious mucocutaneous manifestations, 636 patients (36.2%) had noninfectious manifestations and 63 patients (3.8%) had antiretroviral therapy-associated drug eruptions. The study had more males (52.4%) followed by females (46.9%) and transgenders (0.7%). It is observed that the middle-aged population (21-40 years), as expected, have the majority of patients (57.19%), whereas <10 years (1.02%) had the least, with the youngest being 1 year and the oldest being 80 years.

Conclusion: The study highlights that mucocutaneous manifestations correlate with CD4 count and can aid in early HIV diagnosis and monitoring, especially where CD4 testing is unavailable. Understanding their epidemiological distribution helps design targeted awareness, screening, and prevention programs for high-risk groups.

Introduction: Vulval dermatoses may present with varied manifestations ranging from asymptomatic to chronic disabling conditions. Due to the warm, moist, and frictional environment of the vulva and its frequent exposure to irritating substances such as urine, feces, repeated use of napkins, and vaginal secretions, the classic appearance of common dermatoses is modified.

Aim and objective: To study the pattern of nonvenereal disease of female external genitalia.

Materials and methods: The study involved 50 female participants over a 1-year period, with informed consent obtained from all. A comprehensive history was recorded, including demographic details, skin-related complaints, itching, discoloration, thickening, thinning, darkening, erosion, ulceration, onset, duration, pregnancy, menstrual status, and associated conditions. Sexual exposure history was also noted. A thorough examination of the external genitalia was conducted, along with a full physical assessment for any other body lesions. Relevant investigations were performed to confirm the diagnosis.

Results: The most common age group was 31-40 years. The most common presenting symptom was itching. The most common noninfectious nonvenereal dermatoses were lichen sclerosus (18%), vitiligo (18%), and lichen simplex chronicus (12%). Other dermatoses included lymphedema, invasive squamous cell carcinoma, psoriasis, lichen planus, lymphangioma circumscriptum, irritant contact dermatitis, melanocytic nevi, and drug reaction.

Conclusion: Due to the challenging nature of self-examination of the vulva, individuals may delay in seeking medical attention for genital lesions. This hesitation can result in heightened anxiety and fear, significantly affecting the patient's quality of life by contributing to increased morbidity and disruptions in sexual function.

Herpes simplex virus type 2 (HSV-2) is a common cause of genital herpes but rarely causes encephalitis in immunocompetent adults. We report a case of a 20-year-old immunocompetent woman who developed HSV-2 encephalitis following a primary genital infection. She initially presented with multiple painful genital ulcers and herpetic whitlow, confirmed as primary HSV infection and treated with oral acyclovir. One month later, she developed seizures, confusion, and hallucinations. Magnetic resonance imaging revealed T2/FLAIR hyperintensities in the left cerebral cortex and thalamus, and cerebrospinal fluid polymerase chain reaction detected HSV-2 DNA. Despite intravenous acyclovir therapy, she relapsed after 45 days and succumbed. This case highlights that primary genital HSV-2 infection can have severe and fatal neurological complications even in the absence of immunosuppression. Early recognition, timely antiviral therapy, and vigilance for relapse or autoimmune encephalitis are essential.

Sexually transmitted infections (STIs) remain a major public health problem in most parts of the world. Failure to diagnose and treat STIs at an early stage may result in serious complications, including infertility and other pregnancy comorbidities. The Centers for Disease Control and Prevention released their latest guidelines for the management of various STIs in July 2021 that replaced the 2015 guidelines. The National AIDS Control Organization under Ministry of Health and Family Welfare, Government of India released the latest guidelines for management of various STIs in late 2024. The management protocols have been changed for certain STIs, and there are also notable changes made to the syndromic management kits compared to the previous guidelines. These guidelines have not yet been updated in the current editions of standard venereology or dermatology textbooks. We have brought together the recent treatment guidelines under a single roof in this article. In addition, we have also briefed about the newer treatment options currently available for various STIs. We hope our article will serve as a useful ready reckoner for postgraduates preparing for their examinations and for practicing dermato-venereologists.