Genital elephantiasis and sexually transmitted infections – revisited

2006 ◽  
Vol 17 (3) ◽  
pp. 157-166 ◽  
Author(s):  
Somesh Gupta ◽  
C Ajith ◽  
Amrinder J Kanwar ◽  
Virendra N Sehgal ◽  
Bhushan Kumar ◽  
...  
Keyword(s):  
Sexually Transmitted Infections ◽  
Causative Agent ◽  
Significant Proportion ◽  
Medical Problem ◽  
Nucleic Acid Amplification ◽  
Sexually Transmitted ◽  
Laboratory Facilities ◽  
Laboratory Investigations ◽  
Polymerase Chain ◽  
The Tropics

Genital elephantiasis is an important medical problem in the tropics. It usually affects young and productive age group, and is associated with physical disability and extreme mental anguish. The majority of cases are due to filariasis; however, a small but significant proportion of patients develop genital elephantiasis due to bacterial sexually transmitted infections (STIs), mainly lymphogranuloma venereum (LGV) and donovanosis. STI-related genital elephantiasis should be differentiated from elephantiasis due to other causes, including filariasis, tuberculosis, haematological malignancies, iatrogenic, or dermatological diseases. Laboratory investigations like microscopy of tissue smear and nucleic acid amplification test for donovanosis, and serology and polymerase chain reaction for LGV may help in the diagnosis, but in endemic areas, in the absence of laboratory facilities, diagnosis largely depends on clinical characteristics. The causative agent of LGV, Chlamydia trachomatis serovar L1–L3, is a lymphotropic organism which leads to the development of thrombolymphangitis and perilymphangitis, and lymphadenitis. Long-standing oedema, fibrosis and lymphogranulomatous infiltration result in the final picture of elephantiasis. Elephantiasis in donovanosis is mainly due to constriction of the lymphatics which are trapped in the chronic granulomatous inflammatory response generated by the causative agent, Calymmatobacterium (Klebsiella) granulomatis. The LGV-associated genital elephantiasis should be treated with a prolonged course of doxycycline given orally, while donovanosis should be treated with azithromycin or trimethoprim-sulphamethoxazole combination given for a minimum of three weeks. Genital elephantiasis is not completely reversible with medical therapy alone and often needs to be reduced surgically.

scholarly journals POLYMERASE CHAIN REACTION AS A DIAGNOSTIC TOOL FOR SIX SEXUALLY TRANSMITTED INFECTIONS - PRELIMINARY RESULTS

2015 ◽  
Vol 88 (1) ◽  
pp. 33-37
Author(s):  
Alecsandra Iulia Grad ◽  
Mihaela Laura Vica ◽  
Horea Vladi Matei ◽  
Doru Lucian Grad ◽  
Ioan Coman ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Chlamydia Trachomatis ◽  
Neisseria Gonorrhoeae ◽  
Sexually Transmitted Infections ◽  
Sensitivity And Specificity ◽  
Diagnostic Tool ◽  
High Sensitivity ◽  
Chain Reaction ◽  
Sexually Transmitted ◽  
Polymerase Chain

Background and aim. Sexually transmitted infections are a very frequent and under-diagnosed cause of illness worldwide. A high number of detection methods and a large range of specimens in which sexually transmitted infections can be determined are available at the moment. Polymerase chain reaction performed on first void urine offers the advantage of being non-invasive, self-collectable and has high sensitivity and specificity. We looked to determine the frequency of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma hominis, Mycoplasma genitalium and Ureaplasma urealyticum in symptomatic and asymptomatic patients.Methods. Six sexually transmitted infections were determined in the first void urine of 15 symptomatic and asymptomatic patients by polymerase chain reaction. We used “Epicenter MasterPure™ Complete DNA and RNA Purification Kit” for the DNA purification and “Seeplex® STD6 ACE Detection” for the DNA amplification. The results were examined in UV light.Results. A number of 5 patients had positive results for Chlamydia trachomatis or Neisseria gonorrhoeae. Sexually transmitted infections are more frequent in men between 27 and 40 years old.Conclusions. Polymerase chain reaction is a good diagnostic tool for sexually transmitted infections because it has a high sensitivity and specificity. Chlamydia trachomatis is the most frequent sexually transmitted infection, followed by Neisseria gonorrhoeae.

scholarly journals A clinicoepidemiological study of sexually transmitted infections among men who have sex with men from a tertiary care centre in South India

2017 ◽  
Vol 3 (3) ◽  
pp. 370
Author(s):  
V. G. Binesh ◽  
A. Sarin ◽  
Betsy Ambooken ◽  
S. Suprakasan ◽  
T. P. Rakesh
Keyword(s):  
Sexually Transmitted Infections ◽  
Tertiary Care ◽  
High Risk Population ◽  
Tertiary Care Centre ◽  
Serological Screening ◽  
Sexually Transmitted ◽  
Condom Usage ◽  
Specimen Collection ◽  
Laboratory Investigations ◽  
Sex With Men

<p class="abstract"><strong>Background:</strong> The prevalence of men who have sex with men (MSM) is showing an increasing trend in general population. MSM being a high risk population are more prone to develop sexually transmitted infections (STIs)<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> With the help of Sevana, a nongovernmental organization (NGO), we were able to mobilize 81 MSM for detailed evaluation. All  MSM, after an informed consent were given a behavioural questionnaire, followed by detailed history taking, clinical examination, pre-test counselling and specimen collection.<strong></strong></p><p class="abstract"><strong>Results:</strong> All of them were clinically asymptomatic. Of the total 81 MSM in our study, 27(33.3%) had STIs as evidenced by laboratory investigations. Out of these, 3 (3.7%) had multiple STIs. The most common STI in our study group was asymptomatic herpes gentalis (12.4%), followed by latent syphilis (9.9%) and non gonococcal urethritis (8.6%)<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> The high incidence of asymptomatic STIs among MSMs in our study points to the need for strengthening targeted intervention including condom usage and a compulsory medical check-up and serological screening at least once in six months for early detection and treatment of STIs. This in turn would help us in preventing the transmission of STIs including HIV<span lang="EN-IN">.</span></p>

scholarly journals STI initiative: Improving testing for sexually transmitted infections in women

2018 ◽  
Vol 7 (4) ◽  
pp. e000461 ◽  
Author(s):  
Ryan Christopher Chadwick ◽  
Kathleen McGregor ◽  
Paula Sneath ◽  
Joshua Rempel ◽  
Betty Li Qun He ◽  
...  
Keyword(s):  
Health Care ◽  
Sexually Transmitted Infections ◽  
Economic Cost ◽  
Incidence Rates ◽  
Nucleic Acid Amplification ◽  
Urgent Care ◽  
Quality Improvement Initiative ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Opt Out

Canadian urgent care and walk-in medical clinics provide health care for a population that may be poorly covered by traditional health care structures. Despite evidence suggesting that women with urinary complaints experience a high incidence of sexually transmitted infections (STIs), this population may be under-tested in this particular setting. The aim of this quality improvement initiative was to increase STI testing in women presenting with GU complaints. Implementation of an opt-out method of STI testing for women ages 16 and older was introduced at three walk-in clinics. Women presenting with GU complaints were given the opportunity to provide samples for both conventional urine culture and nucleic acid amplification testing (NAAT) for non-viral STIs. Patients received treatment according to standard of care and public health was notified as per local regulations. Testing rate and STI incidence was tracked via clinic electronic medical records (EMRs). Overall results were tracked using run charts and compared to historical data for the year prior to the start of the project. Over a 1 year period prior to this intervention, only 65 STI tests were performed in over 1100 GU complaints (5.5%). Six STIs were identified during this time. During the 36-week project period, testing increased to 45% of the patient population (320/707). The STI detected incidence increased from 0.51% to 1.4% in all women, and from 0.84% to 3.4% in women aged 16–29 years. An opt-out method was an effective intervention for increasing STI testing within the walk-in clinic setting. With optimisation, significant increases in testing rates can be obtained without substantially increasing clinic workload and at no economic cost to the clinic. As expected, detected incidence rates of STIs were higher than the recognised population prevalence.

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