Unilateral Twin Ectopic Pregnancy in a Patient With a History of Multiple Sexually Transmitted Infections

Background. The incidence of unilateral twin ectopic pregnancy is a rare condition. Several factors increase the risk of ectopic pregnancy, the most important of which is pelvic inflammatory disease, followed by operative trauma, congenital anomalies, tumors, and adhesions resulting in anatomically distorted fallopian tubes. We present a case of a woman with a history of four confirmed sexually transmitted infections (STIs) including Chlamydia trachomatis, Neisseria gonorrhoeae, herpes simplex virus 2, and Treponema pallidum. The case illustrates the potential impact of sexually transmitted infections (STIs) on the risk of a twin ectopic pregnancy. Case. A 24-year-old primigravida, presented with an unknown last menstrual period, lower abdominal pain, watery vaginal discharge, and vaginal spotting. During this hospitalization, serumβ-HCG testing was 263 mIU/mL and transvaginal ultrasonographic examination suggested a nonviable unilateral twin ectopic pregnancy. At exploratory laparotomy, a 10 cm mass involving the right fallopian tube and ovary was excised. Pathological evaluation of the specimen identified a monochorionic, diamnionic twin ectopic pregnancy within the fallopian tube. Conclusions Patients with a history of multiple (STIs) are known to be at risk for the development of chronic pelvic infection and postinflammatory scarring. The resulting distortion of the normal tubal anatomy leads to an increased risk of an uncommon presentation of ectopic pregnancy.

Download Full-text

Ruptured salpingitis isthmica nodosa: a rare cause for spontaneous haemoperitoneum

BMJ Case Reports ◽

10.1136/bcr-2020-237860 ◽

2021 ◽

Vol 14 (1) ◽

pp. e237860

Author(s):

Dora Huang ◽

Sandon Lowe ◽

Pravena Kumaran ◽

Kay Tai Choy

Keyword(s):

Ectopic Pregnancy ◽

Fallopian Tube ◽

Diagnostic Laparoscopy ◽

Lower Abdominal Pain ◽

Atypical Presentation ◽

Pelvic Ultrasound ◽

Beta Human Chorionic Gonadotropin ◽

History Of ◽

Ectopic Pregnancies ◽

The Right

Salpingitis isthmica nodosa (SIN) is the nodular swelling or diverticulum of the isthmus of the fallopian tube. It is most commonly identified when investigating female infertility or in association with ruptured ectopic pregnancies. We experienced a rare and atypical presentation of SIN. A 33-year-old woman presented with a 1-hour history of acute lower abdominal pain associated with nausea and vomiting. CT and pelvic ultrasound revealed haemoperitoneum with no radiological evidence for its aetiology. Initial beta-human chorionic gonadotropin excluded ectopic pregnancy. A diagnostic laparoscopy was performed following clinical deterioration of the patient. Active bleeding of the right fallopian tube was identified and managed with a right partial salpingectomy, with subsequent histopathology revealing ruptured SIN. There have been no reported cases of SIN being a primary cause for an acute abdomen or haemoperitoneum in the absence of an ectopic pregnancy, making this case a surgical novelty.

Download Full-text

Ectopic pregnancy in the ampulla of the fallopian tube at 16 gestational weeks: lessons from a case report

African Health Sciences ◽

10.4314/ahs.v20i4.47 ◽

2020 ◽

Vol 20 (4) ◽

pp. 1895-7

Author(s):

Nnabuike Chibuoke Ngene ◽

Ongombe Lunda

Keyword(s):

Abdominal Pain ◽

Ectopic Pregnancy ◽

Fallopian Tube ◽

Haemoglobin Concentration ◽

Lower Abdominal Pain ◽

First Trimester ◽

Tubal Pregnancy ◽

Emergency Laparotomy ◽

History Of ◽

The Right

Background: It is uncommon to find ampullary tubal pregnancy in the second trimester. Methods: A 35-year-old G4P3 at 16 gestational weeks presented with a day history of sudden severe lower abdominal pain and no vaginal bleeding. The patient had a normal pulse of 82/minutes, haemoglobin concentration of 6.3 g/dl and ultrasonography showed an empty uterus with an alive fetus in the right adnexa. She was provisionally diagnosed to have an abdominal pregnancy. Results: The patient had an emergency laparotomy where 2.2 L of haemoperitoneum and a slow-leaking right ampullary tubal pregnancy were found. Right total salpingectomy was performed and she had an uncomplicated post-operative fol- low-up. Histology of the lesion confirmed tubal pregnancy. Conclusion: The growth of a pregnancy in the ampulla beyond the first trimester is possibly due to increased thickness and or distensibility of the fallopian tube. A tubal pregnancy may present with a normal pulse despite significant haemorrhage. Keywords: Abdominal pain; ampullary tubal ectopic pregnancy; Bezold–Jarish-like reflex.

Download Full-text

Risk of sexually transmitted Zika virus in a cohort of economically disadvantaged urban residents

The Journal of Infectious Diseases ◽

10.1093/infdis/jiab001 ◽

2021 ◽

Author(s):

Juan P Aguilar Ticona ◽

Huma Baig ◽

Nivison Nery Jr. ◽

Simon Doss-Gollin ◽

Gielson A Sacramento ◽

...

Keyword(s):

Sexual Behavior ◽

Sexually Transmitted Infections ◽

Zika Virus ◽

Disease Burden ◽

Urban Community ◽

Urban Residents ◽

Zikv Infection ◽

Retrospective Survey ◽

Sexually Transmitted ◽

Increased Risk

Abstract In order to understand the disease burden of sexually transmitted Zika virus (ZIKV), we prospectively followed a cohort of 359 adult and adolescent residents of an urban community in Salvador, Brazil through the 2015 ZIKV epidemic. Later, in 2017, we used a retrospective survey to associate sexual behavior during the epidemic with ZIKV infection as defined by IgG3-NS1 ELISA. We found that males who engaged in casual sexual encounters during the epidemic were more likely (ORa=6.2; 95%CI 1.2–64.1) to be ZIKV positive, suggesting that specific groups may be at increased risk of sexually transmitted infections.

Download Full-text

IFNL4-ΔG is associated with prostate cancer among men at increased risk of sexually transmitted infections

Communications Biology ◽

10.1038/s42003-018-0193-5 ◽

2018 ◽

Vol 1 (1) ◽

Cited By ~ 14

Author(s):

Tsion Zewdu Minas ◽

Wei Tang ◽

Cheryl J. Smith ◽

Olusegun O. Onabajo ◽

Adeola Obajemu ◽

...

Keyword(s):

Prostate Cancer ◽

Sexually Transmitted Infections ◽

Sexually Transmitted ◽

Increased Risk

Download Full-text

Pattern of Sexually Transmitted Infections: A Retrospective Study from a Tertiary Care Hospital in Central India

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/45933.14464 ◽

2021 ◽

Author(s):

Sushil Rathi ◽

Sumit Ashok Hajare ◽

Saurabh Jaiswal ◽

Sandip Agrawal ◽

Abhijit Kherde ◽

...

Keyword(s):

Sexually Transmitted Infections ◽

Vaginal Discharge ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Lower Abdominal Pain ◽

Care Hospital ◽

Cross Sectional ◽

Adequate Treatment ◽

Major Health ◽

Sexually Transmitted

Introduction: Sexually Transmitted Infections (STIs) pose a major health, social and economic problem worldwide, predominantly in developing countries like India. It is essential to understand the current patterns of STIs in the various regions of the country in order to plan and implement strategies to control the spread of infection. Aim: To study the pattern of STIs among patients attending the STI clinic. Materials and Methods: This was a cross-sectional study of data obtained retrospectively from case records over last seven years (January 2013-December 2019) from STI clinic at a tertiary care hospital at Nagpur. The demographic details, detailed history, clinical findings were noted and relevant investigations were performed. The patients were diagnosed as per syndromic approach and subjected to serologic tests for syphilis and Human Immunodeficiency Virus (HIV). The data was analysed by using MS Excel and Epi Info software, and percentage, mean, standard deviation and proportions were calculated. Results: Out of the total 4471 cases, 2807 (62.8%) were males and 1664 (37.2%) were females. The most commonly observed STI was balanoposthitis, followed by cervico-vaginal discharge, Genital Ulcerative Disease- Herpetic (GUD-H), anogenital warts, molluscum contagiosum, GUD-nonherpetic, urethral discharge, lower abdominal pain and inguinal bubo. The proportion of viral STIs was 33.5% (1495 cases) and bacterial STIs were 4.3% (191 cases). The most commonly observed STI was balanoposthitis in males and cervico-vaginal discharge in females. Newly diagnosed cases of HIV were 1.4% (61 cases) of total cases. Conclusion: The proportion of viral STIs was higher compared to bacterial STIs. The prevalence of HIV among study population was 3.9%. Since STIs are indicators of high risk sexual behaviour in the community and a major health burden with risk of development of HIV, prompt diagnosis and adequate treatment of STIs is necessary.

Download Full-text

Sexual Behaviors and Sexually Transmitted Infections Among Male Veterans and Nonveterans

American Journal of Men s Health ◽

10.1177/1557988317698615 ◽

2017 ◽

Vol 11 (4) ◽

pp. 791-800 ◽

Cited By ~ 5

Author(s):

Mark W. Evans ◽

Sonya Borrero ◽

Jonathan Yabes ◽

Elian A. Rosenfeld

Keyword(s):

Marital Status ◽

Sexually Transmitted Infections ◽

Sexual Behaviors ◽

Care Providers ◽

Sexually Transmitted ◽

Female Partners ◽

The Past ◽

Male Veterans ◽

Veteran Status ◽

History Of

Little is known about the sexual health of male veterans. This study used nationally representative data from the 2011 to 2013 National Survey of Family Growth to compare sexual behaviors and history of sexually transmitted infections (STIs) between male veterans and nonveterans. The sample included 3,860 men aged 18 to 44 years who reported ever having sex with a man or woman. The key independent variable was veteran status. Sexual behavior outcomes included ≥6 lifetime female partners, ≥10 lifetime partners of either sex, ≥2 past-year partners of either sex, having past-year partners of both sexes, and condom nonuse at last vaginal sex. STI outcomes included past-year history of chlamydia, gonorrhea, or receiving any STI treatment; lifetime history of herpes, genital warts, or syphilis; and an aggregate measure capturing any reported STI history. Logistic regression models were used to evaluate associations between veteran status and each outcome. In models adjusting for age, race/ethnicity, education, income, and marital status, veterans had significantly greater odds than nonveterans of having ≥6 lifetime female partners ( OR = 1.5, 95% CI [1.02, 2.31]). In models adjusting for age and marital status, veterans had significantly greater odds of having partners of both sexes in the past year ( OR = 4.8, 95% CI [1.2, 19.8]), and gonorrhea in the past year ( OR = 3.2, 95% CI [1.2, 8.5]). Male veterans were thus significantly more likely than nonveterans to have STI risk factors. Health care providers should be aware that male veterans may be at higher risk for STIs and assess veterans’ sexual risk behaviors.

Download Full-text

Pelvic inflammatory disease

Oxford Textbook of Obstetrics and Gynaecology ◽

10.1093/med/9780198766360.003.0043 ◽

2020 ◽

pp. 536-549

Author(s):

Gillian Dean ◽

Jonathan Ross

Keyword(s):

Ectopic Pregnancy ◽

Pelvic Inflammatory Disease ◽

Inflammatory Disease ◽

Severe Disease ◽

Lower Abdominal Pain ◽

Asymptomatic Infection ◽

Public Understanding ◽

Transmitted Infection ◽

Delay In Diagnosis ◽

Sexually Transmitted

Pelvic inflammatory disease is a sexually transmitted infection of the female upper genital tract. Rates of pelvic inflammatory disease have fallen in many countries over the last 10 years, at least in part due to increased screening for chlamydial infection. The clinical spectrum ranges from asymptomatic infection through to severe disease requiring hospitalization. Due to the non-specific nature of the condition, diagnosis can be challenging. All sexually active women presenting with acute lower abdominal pain should have a pregnancy test to rule out ectopic pregnancy. Treatment must be initiated as soon as the diagnosis is suspected and include antibiotics covering a broad spectrum of pathogens. Delay in diagnosis increases the risk of adverse sequelae including ectopic pregnancy and infertility. It is recommended that current and recent sexual partners receive empirical treatment, regardless of symptoms or microbiological results, and refrain from sexual contact until completion of therapy. Through better public understanding of the symptoms of pelvic inflammatory disease, women seeking earlier medical attention may reduce the risk of reproductive damage.

Download Full-text

Sexually transmitted infections in young people and factors associated with HIV coinfection: an observational study in a large city

BMJ Open ◽

10.1136/bmjopen-2018-027245 ◽

2019 ◽

Vol 9 (5) ◽

pp. e027245 ◽

Cited By ~ 7

Author(s):

Alexis Sentís ◽

Mario Martin-Sanchez ◽

Maider Arando ◽

Martí Vall ◽

María Jesus Barbera ◽

...

Keyword(s):

Young People ◽

Sexually Transmitted Infections ◽

Large City ◽

Epidemiological Surveillance ◽

Sexually Transmitted ◽

Factors Associated ◽

Hiv Coinfection ◽

Increased Risk ◽

Sex With Men ◽

Epidemiological Characteristics

ObjectivesYoung people are a critical target group for sexually transmitted infections (STI) surveillance due to their particular behavioural and social related vulnerability. The aim of this study was to describe the epidemiological characteristics and trends in the incidence of gonorrhoea, syphilis, HIV and venereal lymphogranuloma (LGV) among 15–24-year-olds in Barcelona, and to determine factors associated with HIV coinfection.DesignWe performed a population-based incidence study covering the 2007–2015 period.ParticipantsAll new cases of STI—HIV, gonorrhoea, infectious syphilis and LGV—notified to the epidemiological surveillance system in Barcelona between 2007 and 2015. 1218 cases were studied: 84.6% were men, 19.3% were 15–19 years old and 50.6% were born in Spain. Among men, 73.7% were men who have sex with men (MSM); among women, 85.6% were women that have sex with men.Primary and secondary outcomesIncidence of HIV, gonorrhoea, infectious syphilis and LGV. HIV coinfection.ResultsThere was an increase in the incidence of gonorrhoea, from 1.9 cases per 10 000 people in 2007 to 7.6/10 000 in 2015 (p<0.01), in MSM from 27.1 to 228.8/10 000 (p<0.01). The incidence of syphilis increased from 0.4/10 000 in 2007 to 3.1/10 000 in 2015 (significant in men only, p<0.01), in MSM from 18.1 to 116.9/10 000 (p<0.01). The incidence of HIV showed a non-significant increase in men (p=0.27), and that of LGV remained stable (p=0.59). Factors associated with increased risk of HIV coinfection included being MSM (adjusted OR[ORa]=14.14, 95% CI 3.34 to 59.91) and having >10 sexual partners (ORa=4.11, 95% CI 1.53 to 11.01) or STI diagnosis during the previous 12 months (ORa=2.06; 95% CI 1.13 to 3.77).ConclusionsThe incidence of gonorrhoea and syphilis among 15–24-year-olds increased, while HIV infection remained stable but with a high incidence among MSM. Being MSM, having sex with multiple partners and having a diagnosis of an STI in the previous 12 months were factors associated with HIV coinfection.

Download Full-text

The diagnosis of hepatitis C in a semi-rural genitourinary medicine clinic

International Journal of STD & AIDS ◽

10.1258/095646202321020143 ◽

2002 ◽

Vol 13 (12) ◽

pp. 847-849

Author(s):

A R Markos

Keyword(s):

Risk Factors ◽

Hepatitis C ◽

Drug Use ◽

Sexually Transmitted Infections ◽

Intravenous Drug Use ◽

Sex Partners ◽

Routine Test ◽

Sexually Transmitted ◽

History Of ◽

Genitourinary Medicine

A retrospective casenote study was conducted to examine the risk factors for patients who were diagnosed as hepatitis C (HCV)-positive (between 1999 and 2001) in a semi-rural genitourinary medicine (GUM) setting in Staffordshire, UK. There was a remarkable escalation in the number of reported HCV-positive cases, year on year, in our study. The majority of the positive cases (20/21) gave a history of previous intravenous drug use (IVDU). The incidence of other sexually transmitted infections were reportedly high in our HCV-positive patients. The increasing number of reported HCV-positive cases in the GUM clinic of the semirural Staffordshire setting, may reflect a national pattern that needs further investigations. We advise that HCV serology should be offered to GUM clients (who have a history of IVDU), and to their sex partners. They should also be advised to take tests to exclude other STDs. The case for offering HCV serology as a routine test for patients who request 'the exclusion of STDs' is still undecided.

Download Full-text