Indian Journal of Sexually Transmitted Diseases and AIDS最新文献

Charcot arthropathy is characterized by joint dislocations, pathologic fractures, and debilitating deformities. Syphilis was believed to be the most common cause of Charcot arthropathy a century back, but now, it is one of the rare causes which get missed in the routine evaluation. We present a rare case of syphilitic Charcot joint in a middle aged, paraplegic, wheel-chaired bound male, who presented with a history of recurrent painless joint swelling. He underwent multiple surgeries on the left elbow to deal with his soft tissues and bony infections along with multiple courses of systemic high end antibiotics including anti-tubercular drugs without much benefit. He was even planned for midarm amputation. Timely opinion of dermatologist and correct interpretation of serological tests clinched the diagnosis. This case highlights a high index of suspicion and correct interpretation of serological test of syphilis is essential to diagnose tertiary syphilis. Timely management with injection benzathine penicllin resulted in life time gratifying outcome.

Context: Molluscum contagiosum (MC) typically presents as asymptomatic or itchy, discrete, smooth, flesh-colored, dome-shaped papules with central umbilication. Lesions on the genitals are often sexually transmitted and tend to be seen in young adults. Homologous auto implantation is a simple technique which helps in inducing a cell-mediated immune response to the antigens, aiding clearance of both local and distant lesions.

Aim and objectives: The aim of the study is to evaluate the efficacy and side effect of the technique of autoinoculation for the treatment of genital MC in terms of reduction in number of lesions.

Materials and methods: Thirty-one patients having >5 genital molluscum attending skin outpatient department were enrolled out of which 30 remain. A well-defined mc lesion was approached using an insulin syringe (30 G) and pierced from a site just adjacent to the lesion. Results were assessed every 2 weeks for 2 months.

Results: 60% (n = 18) patients showed excellent response, 20% (n = 6) patients showed very good response, 6.6% (n = 2) patients showed good response and 13.3% (n = 4) showed poor response at the end of the study.

Conclusion: The autoinoculation technique is an effective technique in terms of excellent clearance of MC lesions with fewer chances of recurrence, side effects, and shorter duration taken to achieve a complete response to distant lesions.

Angiosarcoma (AS) is a rare malignant tumor of vascular or lymphatic epithelium, typically presenting as a bruise-like patch over the face or scalp in the seventh-ninth decades. Here, we report a case of cutaneous AS (cAS) in a 51-year-old male patient who presented with a cauliflower-like growth in the groin with skin-colored shiny flat-topped satellite papules in the surrounding areas, some of which were umbilicated. Based on examination, the patient was considered retro positive and the following differentials were considered: Buschke-Lowenstein tumor with giant molluscum, Kaposi sarcoma, and squamous cell carcinoma. Histopathological examination suggested the diagnosis as AS, which was confirmed by immunohistochemistry that was positive for CD31 and CD34. The report highlights the unusual site and clinical presentation of cAS.

Mother to child transmission still accounts for thousands of children being affected with human immunodeficiency virus (HIV) yearly. These children are often detected late in their disease course, most commonly presenting as protein energy malnutrition. Here we present a unique pediatric case who presented with severe symptomatic hypocalcemia. The case highlights the importance of vitamin D and calcium screening in this subgroup of HIV patients.

Context: During pregnancy, sexually transmitted infections can be transmitted vertically to the fetus, leading to an increase in morbidity and mortality for both mother and child.

Aims: This study aimed to determine the profile of cervical and vaginal infections in pregnant women receiving prenatal care in a single institute.

Settings and design: The study was conducted in a tertiary hospital. Molecular testing was used to detect Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and Trichomonas vaginalis.

Materials and methods: Samples of vaginal secretions were collected from pregnant women using the Aptima^® Multitest Swab Specimen Collection kit to test for the pathogens. The inclusion criteria consisted of pregnant women of 15-45 years of age receiving prenatal care at the institute, irrespective of gestational age, who agreed to provide vaginal swab. The exclusion criterion was the use of antibiotics in the preceding 3 months.

Statistical analysis: Frequencies and percentages were calculated for the pathogens detected in the samples evaluated.

Results: Overall, 200 samples were tested. Of the pathogens detected, there was a predominance of T. vaginalis (15.5% of the samples) and C. trachomatis (14.5%), followed by M. genitalium (10.0%) and N. gonorrhoeae (0.5%).

Conclusion: Identifying the microorganisms present in the microbiota of pregnant women is of the utmost importance in assuring the appropriate treatment for each pathogen, thus avoiding complications both for the woman and for her fetus. These results should serve to stimulate the debate on implementing these tests as routine during prenatal care.

Cryptococcosis is caused by the inhalation of the desiccated encapsulated yeast or basidiospores, which are found in the environment. After the infectious particles reach the lungs, get disseminated hematogenously in various organs. Meningoencephalitis is one of the most common manifestations, especially in sub-Saharan Africa. The dermal lesions can be either primary due to the traumatic implantation of infectious propagule or secondary in patients with disseminated infection due to cryptococcus. The typical presentations of the cutaneous lesions are like umbilicated lesions of molluscum contagiosum. The dermal lesions can also be similar to Kaposi sarcoma or talaromycosis (formerly penicilliosis). Here, we present a 34-year-old male HIV-positive and antiretroviral therapy-naive. The patient had a very low CD4 cell count and a high viral load. The patient was referred to the dermatology clinic for multiple eruptions due to umbilicated skin colored lesions 3-5 mm in diameter on the nose.The patient was first treated for the opportunistic infection. The causes of the dermal umbilicated skin lesions are several. We must find out whether the dermal lesion is due to infection with a single organism or more than one. It can be colesional also. Punch biopsy, India ink, and culture on Sabouraud dextrose agar confirmed the diagnosis of Cryptococcus neoformans.