Unusual presentation of a periurethral abscess following infection with Neisseria gonorrhoea

2022 ◽  
Vol 15 (1) ◽  
pp. e246494
Author(s):  
Robin Shepherd ◽  
Alexandra Crossland ◽  
Rafal Turo ◽  
Michelle Christodoulidou
Keyword(s):  
Unusual Case ◽  
Rare Complication ◽  
Health Centre ◽  
Contact Tracing ◽  
Abscess Drainage ◽  
Sexually Transmitted ◽  
Neisseria Gonorrhoea ◽  
Urethral Fistula ◽  
Penile Injury ◽  
Urethral Lesion

We describe an unusual case of a male patient presenting with penile and testicular swelling following an unprotected and traumatic sexual encounter. It was suspected that an isolated penile injury occurred during intercourse; however, ultrasound imaging identified an intact tunical layer and right-sided epididymo-orchitis. Following screening for sexually transmitted infections (STIs), he was discharged with antibiotics and advice to attend the Sexual Health Centre for contact tracing. He represented with a periurethral abscess and an antimicrobial-resistant (AMR) strain of Neisseria gonorrhoea was identified. Appropriate antibiotic treatment was initiated. Examination-under-anaesthesia, following abscess drainage, revealed a contained collection with no urethral fistula; however, a flat urethral lesion was seen during urethroscopy. Repeat urethroscopy and biopsy of the lesion indicated polypoid urethritis. Periurethral abscess secondary to gonococcal urethritis is a rare complication, but one that we should be suspicious of, especially with the growing incidence of AMR-STIs.

scholarly journals Chlamydia trachomatis and Neisseria gonorrhoea Co-Infection Among Patients Attending a Teaching Hospital in Nairobi County: A Retrospective Study

2021 ◽  
Vol 3 (1) ◽  
pp. 51-57
Author(s):  
Festus Mulakoli
Keyword(s):  
Retrospective Study ◽  
Chlamydia Trachomatis ◽  
Laboratory Data ◽  
Contact Tracing ◽  
Tertiary Institution ◽  
Chlamydia Trachomatis Infection ◽  
Sexually Transmitted ◽  
Neisseria Gonorrhoea ◽  
Male Patients ◽  
Health Complications

Background: Chlamydia trachomatis and Neisseria gonorrhoea are microbes that have been associated with urethritis in both male and female genders, which often may lead to complicated conditions such as pelvic inflammatory disease (PID) and infertility globally among others health complications. In Kenya and other developing countries, sexually transmitted infections associated with Chlamydia trachomatis and Neisseria gonorrhoea still pose a challenge in public health. Methods: A retrospective study was conducted by reviewing laboratory data from Jan 2018 to Dec 2018 to estimate the prevalence of C trachomatis and N gonorrhoea coinfections in patients attending a tertiary institution and its satellite clinics spread across the country. A total of 1228 patient’s data aged 3-69 years was reviewed; with age, gender and Chlamydia trachomatis and Neisseria gonorrhoea status being analyzed. Results: A total of 1228 patients who visited the hospital in 2018 had their urine samples being tested for Chlamydia trachomatis and Neisseria gonorrhoea by use of a PCR technique. Majority of the patients were males (63.7%). The patients who tested for Chlamydia trachomatis and Neisseria gonorrhoea had an average age of 34 years (range: 3–69 years). Of those 1.4% tested positive for both Chlamydia trachomatis and Neisseria gonorrhoea infections, and males were more infected than females (1.1% vs 0.3). From the information gathered during the study period, the proportion of patients with Chlamydia trachomatis infection was (16.1 %) (95 % CI 9.5, 17.9), and with N. gonorrhoea infection was 5.4%. Coinfection was highest among sexually active group that is those aged between 21 years to 40 years. Conclusion: The prevalence of C. trachomatis is significantly high among male patients. We recommend the implement a molecular screening for Chlamydia trachomatis and Neisseria gonorrhoea to identifying asymptomatic female cases. This study further provides evidence on the importance of contact tracing in the management of Chlamydia trachomatis and other STIs. There is an urgent need for studies designed to investigate the prevalence and risk factors of Chlamydia trachomatis and Neisseria gonorrhoea among female patients who are majorly asymptomatic in Kenya.

An audit of contact tracing for cases of chlamydia in the Australian Capital Territory

Sexual Health ◽  
2005 ◽  
Vol 2 (4) ◽  
pp. 255 ◽  
Author(s):  
Danelle O. England ◽  
Marian J. Currie ◽  
Francis J Bowden
Keyword(s):  
Health Centre ◽  
Contact Tracing ◽  
Chlamydia Infection ◽  
Chlamydia Screening ◽  
Australian Capital Territory ◽  
Background Rate ◽  
Sexually Transmitted ◽  
Australian Capital ◽  
Sexual Contacts ◽  
Index Cases

Background: Contact tracing is one of the central pillars of the management of sexually transmitted infections. The aims of this audit were to determine the yield of chlamydia infection from contact tracing the sexual partners of individuals diagnosed with chlamydia and to evaluate and compare the effectiveness of contact tracing undertaken at the Communicable Diseases Control Section (CDCS) of Australian Capital Territory (ACT) Health and the Canberra Sexual Health Centre (the clinic). Methods: A retrospective review of the notification records and contact-tracing documentation was undertaken at CDCS and the clinic from 1 September 2002 to 30 September 2003 (13 months). Results: The background rate of chlamydia in those tested in the ACT community is 3–5%. During the study period, 512 cases of chlamydia were notified to CDCS. Of these, 351 were referred for contact tracing, 293 by CDCS and 98 by the clinic. Of the 437 nominated sexual contacts (average of 1.12 per index case), 272 (62.2%) were contacted, 125 (28.6%) were tested and 51 (11.7%; 95% CI 8.8–15.1) tested positive for chlamydia (15.5%; 95% CI 11.5–20.6% in sexual contacts of CDCS index cases and 7.8%; 95% CI 4.8–12.5% in those of the clinic patients). Contact tracing through the CDCS reached significantly more nominated sexual contacts (78.4% v. 41.7%; P = 0.001) and significantly more of the nominated sexual contacts of index cases reported to CDCS were described as tested (34.7% v. 20.8%; P = 0.01). The average time taken to identify each chlamydia-positive sexual contact was 6.8 hours. Conclusions: Contact tracing more than doubled the case finding effectiveness of chlamydia screening, but was time consuming. These results suggest that provider-initiated contact tracing has clinical and public health value, but that the cost-effectiveness of this approach to chlamydia control should be further evaluated.

scholarly journals Trends and differences in sexual practices and sexually transmitted infections in men who have sex with men only (MSMO) and men who have sex with men and women (MSMW): a repeated cross-sectional study in Melbourne, Australia

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e037608
Author(s):  
Mario Martín-Sánchez ◽  
Richard Case ◽  
Christopher Fairley ◽  
Jane S Hocking ◽  
Catriona Bradshaw ◽  
...  
Keyword(s):  
Health Centre ◽  
Cross Sectional Study ◽  
Sexual Practices ◽  
Sectional Study ◽  
Anal Sex ◽  
Cross Sectional ◽  
Men And Women ◽  
Sexually Transmitted ◽  
Receptive Anal Sex ◽  
Sex With Men

ObjectivesIn the 2010s, there has been an increase in sexually transmitted infections (STI) in men who have sex with men (MSM) in Australia, and since 2015 also in urban heterosexuals. Men who have sex with both men and women (MSMW) have characteristics that may differ from both men who have sex with men only (MSMO) and heterosexual men. We aimed to compare the sexual practices and the trends in HIV/STI positivity between MSMO and MSMW.DesignRepeated cross-sectional study.SettingA sexual health centre in Melbourne, Australia.ParticipantsMSM aged 18 years and above who attended the Melbourne Sexual Health Centre for the first time between 2011 and 2018. This includes 12 795 MSMO and 1979 MSMW.Primary outcome measuresDemographic characterics, sexual practices and HIV/STI positivity.ResultsCompared with MSMW, MSMO were more likely to practice anal sex and to have condomless receptive anal sex with casual male partners, and less likely to have a current regular relationship. Over the 8-year period, there was an increase in condomless receptive anal sex with casual male partners for both groups (MSMO: from 46.2% to 63.3%, ptrend <0.001; MSMW: from 41.3% to 57.9%, ptrend=0.011). Syphilis positivity increased in MSMO (from 5.5% to 7.9%, ptrend=0.012) and MSMW (from 0.9% to 6.4%, ptrend=0.004) and HIV remained stable. Gonorrhoea increased among MSMO from 2011 to 2014 (from 6.7% to 9.6%, ptrend=0.002), and remained stable from 2015 to 2018. MSMO had higher odds of testing positive for gonorrhoea (adjusted OR (aOR) 1.36, 95% CI 1.13 to 1.64), chlamydia (aOR 1.39, 95% CI 1.16 to 1.67), syphilis (aOR 1.74, 95% CI 1.37 to 2.22) and HIV (aOR 4.60, 95% CI 2.43 to 8.70) than MSMW.ConclusionsMSMW have overall lower condomless sex and lower HIV/STI positivity. In the last years, changes in sexual practices in MSM have affected both MSMW and MSMO leading to an increased STI risk.

Comparison of the patterns of chlamydia and gonorrhoea at the oropharynx, anorectum and urethra among men who have sex with men

2021 ◽  
pp. sextrans-2020-054632
Author(s):  
Marjan Tabesh ◽  
Christopher K Fairley ◽  
Jane S Hocking ◽  
Deborah A Williamson ◽  
Lei Zhang ◽  
...  
Keyword(s):  
Health Centre ◽  
Single Site ◽  
Chlamydia Infection ◽  
Similar Proportion ◽  
Anatomical Site ◽  
Site Infection ◽  
Site Specific ◽  
Sexually Transmitted ◽  
Sex With Men ◽  
First Time

ObjectiveChlamydia and gonorrhoea are common sexually transmitted infections that infect the oropharynx, anorectum and urethra in men who have sex with men (MSM). This study aimed to examine the pattern of infection at more than one site (multisite) for chlamydia and gonorrhoea among MSM.MethodsThis was a retrospective study of MSM attending the Melbourne Sexual Health Centre for the first time between 2018 and 2019. We included MSM aged ≥16 years who had tested for Neisseria gonorrhoeae and Chlamydia trachomatis at all three sites (oropharynx, anorectum and urethra). We compared infections that occurred at a single site (termed single-site infection) and those that occurred at more than one site (termed multisite infections).ResultsOf the 3938 men who were tested for chlamydia and gonorrhoea, 498/3938 men (12.6%, 95% CI 11.5% to 13.6%) had chlamydia at any site, of whom 400/498 (80.3%, 95% CI 78.9% to 81.2%) had single-site chlamydia infection, and 98/498 (19.7%, 95% CI 16.2% to 23.1%) had multisite infections. A similar proportion of men had gonorrhoea at any site (447/3938, 11.4%, 95% CI 10.3% to 12.2%), but among these 447 men, single-site infection was less common (256/447, 57.3%, 95% CI 52.6% to 61.7%, p<0.001) and multisite infection (191/447, 42.7%, 95% CI 38.2% to 47.3%, p<0.001) was more common than chlamydia. There were also marked differences by anatomical site. Urethral infection commonly occurred as single sites (75/122, 61.5%, 95% CI 52.8% to 70.1%) for chlamydia but uncommonly occurred for gonorrhoea (12/100, 12.0%, 95% CI 5.6% to 18.3%, p<0.001). In contrast, anorectal infection uncommonly occurred as multisite infection for chlamydia (98/394, 24.9%, 95% CI 20.6% to 29.1%) but was common (184/309, 59.5%, 95% CI 54.0% to 64.9%, p<0.001) for gonorrhoea.ConclusionsThe markedly different pattern of site-specific infection for chlamydia and gonorrhoea infections among the same MSM suggests significant differences in the transmissibility between anatomical sites and the duration of each infection at each site.

Retrieval of an Unusually Displaced Implant With Healing Cap Into the Mandibular Canal

2018 ◽  
Vol 44 (5) ◽  
pp. 341-343
Author(s):  
Vugar Gurbanov ◽  
Damla Torul ◽  
Dilara Kazan
Keyword(s):  
Psychological Distress ◽  
Dental Implants ◽  
Dental Implant ◽  
Tissue Damage ◽  
Unusual Case ◽  
Preoperative Planning ◽  
Rare Complication ◽  
Mandibular Canal ◽  
Functional Disturbance

Accidental displacement of dental implants into the anatomical spaces is a rare complication that may be accompanied by tissue damage, functional disturbance, psychological distress, and medicolegal conditions. The aim of this report is to present an unusual case of a dental implant that displaced into the mandibular canal and to highlight the importance of adequate preoperative planning and surgical knowledge.

A taxonomy of the scope and organization of local sexually transmitted disease services for policy and practice

2018 ◽  
Vol 29 (14) ◽  
pp. 1375-1383
Author(s):  
Hector P Rodriguez ◽  
Summer Starling ◽  
Zosha Kandel ◽  
Robert Weech-Maldonado ◽  
Nicholas J Moss ◽  
...  
Keyword(s):  
Cluster Analysis ◽  
Discriminant Analysis ◽  
Critical Role ◽  
Transmitted Disease ◽  
The United States ◽  
Incidence Rates ◽  
Contact Tracing ◽  
Cluster Solution ◽  
Local Health ◽  
Sexually Transmitted

Local health departments (LHDs) and their organizational partners play a critical role in controlling sexually transmitted diseases (STDs) in the United States. We examine variation in the differentiation, integration, and concentration (DIC) of STD services and develop a taxonomy describing the scope and organization of local STD services. LHD STD programs (n = 115) in Alabama (AL) and California (CA) responded to surveys assessing STD services available in 2014. K-means cluster analysis identified LHD groupings based on DIC variation. Discriminant analysis validated cluster solutions. Differences in organizational partnerships and scope of STD services were compared by taxonomy category. Multivariable regression models estimated the association of the STD services organization taxonomy and five-year (2010–2014) gonorrhea incidence rates, controlling for county-level sociodemographics and resources. A three-cluster solution was identified: (1) low DIC (n = 74), (2) moderate DIC (n = 31), and (3) high DIC (n = 10). In discriminant analysis, 95% of jurisdictions were classified into the same types as originally assigned through K-means cluster analysis. High DIC jurisdictions were more likely (p < 0.001) to partner with most organizations than moderate and low DIC jurisdictions, and more likely (p < 0.001) to conduct STD needs assessment, comprehensive sex education, and targeted screening. In contrast, contact tracing, case management, and investigations were conducted similarly across jurisdictions. In adjusted analyses, there were no differences in gonorrhea incidence rates by category. Jurisdictions in CA and AL can be characterized into three distinct clusters based on the DIC of STD services. Taxonomic analyses may aid in improving the reach and effectiveness of STD services.

scholarly journals Sexually transmitted infections (STIs) in gynae-outpatients: Experience from a tertiary health centre

Health ◽  
2012 ◽  
Vol 04 (05) ◽  
pp. 268-270
Author(s):  
Harpreet Kaur ◽  
Parveen Marwah ◽  
Surjit Kaur Bajwa ◽  
Amarjit Kaur Gill ◽  
Manjit Singh Bal
Keyword(s):  
Sexually Transmitted Infections ◽  
Health Centre ◽  
Sexually Transmitted

scholarly journals Men treated for syphilis in Białystok, Poland, 2014-2018

2019 ◽  
pp. 329-335
Author(s):  
Agnieszka Beata Serwin ◽  
Adriana Grochowska ◽  
Iwona Flisiak
Keyword(s):  
Urban Areas ◽  
Partner Notification ◽  
Secondary Syphilis ◽  
Contact Tracing ◽  
Professional Activity ◽  
Symptomatic Infection ◽  
Sexually Transmitted ◽  
Sexual Contacts ◽  
Sex With Men

INTRODUCTION. Incidence of syphilis is increasing in Europe in recent years, mainly due to high incidence in men, especially men who have sex with men (MSM). AIM. To analyse sociodemographic, epidemiological and clinical characteristics of men treated for syphilis in Bialystok in 2014 – 2018, to compare these of MSM and men who have sex with women (MSW). MATERIAL AND METHODS. Analysis of age, residency, professional activity, type of sexual contacts (steady vs. casual), marital status, stage of syphilis diagnosed, concomitant sexually transmitted infections (STIs), treatment, partner notification and follow-up attendance. RESULTS. Of 49 male patients with syphilis 26 (53.06%) were MSM and 23 (46.94%) – MSW. The average age was 33.67 and 35.87 years in MSM and MSW patients, respectively. Majority of patients in both groups were residents of urban areas. Tradesmen and those unemployed constituted the highest proportion in MSM and MSW group, respectively. MSM were in majority single and had only casual contacts while MSW, mostly married or engaged in steady relationship, had also casual contacts. Secondary syphilis was most frequently diagnosed in MSM and late latent syphilis - in MSW. Eight patients (16.32%) had concomitant HIV infection, in all diagnosed before syphilis. Contact tracing was successful in 26.92% of MSM and 39.13% of MSW. Follow-up was not done or not completed in half of MSM and more than half of MSW. CONCLUSIONS. Results confirm that MSM play a crucial role in the current epidemics of syphilis. They have mainly casual sexual contacts and have symptomatic infection. In both MSM and MSW contact tracing and follow-up attendance is suboptimal.

scholarly journals Male Urethritis Caused by Trichomonas vaginalis

2021 ◽  
Vol 79 (1) ◽  
pp. 71-73
Author(s):  
Ângela Roda ◽  
João Borges-Costa
Keyword(s):  
Sexually Transmitted Infections ◽  
Sexually Transmitted Diseases ◽  
Trichomonas Vaginalis ◽  
Unusual Case ◽  
Parasitic Infection ◽  
Men And Women ◽  
Sexually Transmitted ◽  
Molecular Assays ◽  
The Past ◽  
The Impact

Trichomoniasis is one of the most common sexually transmitted infections worldwide. In women, Trichomonas vaginalis infection may present with vaginitis, cervicitis, or pelvic inflammatory disease, while in men it is mainly asymptomatic or causes mild and transient symptoms of urethritis, epididymitis, or prostatitis. In the past, little importance had been given to the impact of T. vaginalis infection on men’s health, since it was believed to be a self-limited condition without sequelae. However, there is growing evidence it is associated with more serious disorders in both men and women and efforts to diagnose and treat this parasitic infection have increased. Recent advances in testing for sexually transmitted diseases using multiplex molecular assays have increased diagnostic opportunities for T. vaginalis infection, especially in men, as detection of the parasite by traditional methods is much more challenging. We describe an unusual case of male urethritis caused by T. vaginalis observed in our consultation of Sexually Transmitted Infections.

scholarly journals Prevalence of sexually transmitted infections among pregnant women attending antenatal clinics in West Coast Region of The Gambia

2021 ◽  
Vol 21 (2) ◽  
pp. 585-592
Author(s):  
Alphonsus Isara ◽  
Aru-Kumba Baldeh
Keyword(s):  
Pregnant Women ◽  
Sexually Transmitted Infections ◽  
West Coast ◽  
Trichomonas Vaginalis ◽  
The Gambia ◽  
Age Group ◽  
The West ◽  
Sexually Transmitted ◽  
Neisseria Gonorrhoea ◽  
Coast Region

Background: Sexually Transmitted Infections (STI) are the second most common cause of healthy life years lost by women in the 15 – 44 years age group in Africa. Aim/Objective: To determine the prevalence of STIs among pregnant women attending antenatal care (ANC) clinics in the West Coast Region of The Gambia. Materials and Methods: Blood, urine, and high vaginal swabs samples from 280 pregnant women attending ANC in Brika- ma District Hospital, Brikama, and Bandung Maternity and Child Health Hospital, Bandung were examined. Serum samples were tested for HIV using western blot technique and for syphilis using the Venereal Disease Research Laboratory (VDRL) test, and rapid plasma regimen. Candida albicans, Group B Streptococcus and Neisseria gonorrhoea were identified using Analytical Profile Index (API). Direct urine microscopy was used to identify C. albicans and Trichomonas vaginalis while Chlamydia trachomatis was identified using Direct Fluorescent Antibody (DFA) test. Results: The overall prevalence of STIs was 53.6%. The pathogenic agents isolated were Candida albicans (31.8%), Strep- tococcus agalactiae (15.0%), Treponema pallidum (6.8%), HIV (5.7%), Trichomonas vaginalis (3.9%), Neisseria gonorrhoea (1.8%) and Chlamydia trachomatis (0.7%). STIs were more prevalent among women in the younger age group of 15 – 24 years (54.7%), unemployed (54.0%), Primipara (62.3%), and in the third trimester of pregnancy (72.7%). Conclusion: A high prevalence of STIs was found among pregnant women attending ANC in the West Coast region of The Gambia. Public health intervention programmes should be strengthened to promote the sexual and reproductive health of pregnant women in The Gambia. Keywords: Sexually transmitted infections; pregnant women; antenatal clinics; The Gambia.

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