La malattia infiammatoria pelvica

The paper describes a case of Pelvic Inflammatory Disease (PID) in a fourteen-year-old girl who presented with salpingitis, low abdominal pain, fever, high inflammation indexes and infection by Chlamydia trachomatis and Gardnerella. As guidelines suggest, she was treated with doxycycline, metronidazole and ceftriaxone and her clinical conditions rapidly improved. PID can develop also in teenagers, especially if sexually active, and it must be differentiated from other causes of acute abdomen. The diagnosis can be based on the presence of pain and on at least one criterion between clinical objectivity (fever, vaginal secretions) and laboratory data (vaginal swab, blood exams, vaginal secretion microscopic analysis). Instrumental exams can support the diagnosis but sometimes only laparoscopy and biopsy can reveal a condition of PID. Adequate antibiotic treatment should be performed to avoid complications over future reproductive life.

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Prevalence of Chlamydia trachomatis among young German adolescents, 2005 - 06

Sexual Health ◽

10.1071/sh10036 ◽

2011 ◽

Vol 8 (1) ◽

pp. 120 ◽

Cited By ~ 7

Author(s):

Sarika Desai ◽

Thomas Meyer ◽

Michael Thamm ◽

Osamah Hamouda ◽

Viviane Bremer

Keyword(s):

Abdominal Pain ◽

Chlamydia Trachomatis ◽

Contraceptive Use ◽

Univariate Analysis ◽

Population Based ◽

Sexually Active ◽

Strand Displacement Amplification ◽

Oral Contraceptive Use ◽

Stratified Sample ◽

Socio Demographic Factors

Background: Chlamydia trachomatis prevalence among 12–17-year-old adolescents in Germany was determined in the present study. Methods: A random age-stratified sample of 1815 urine specimens of boys and girls was selected from a population-based nationwide health survey conducted in 2003–06. Urine samples were pooled and tested for chlamydia using strand displacement amplification. Positive pools were individually retested. Prevalence, prevalence ratios (PR) and corresponding 95% confidence intervals (CI) were calculated. Associations between infection and socio-demographic factors (age, sex, place of residence), sexual activity (defined by oral contraceptive use or gynaecologist visits) and abdominal pain among females were examined in univariate analysis. Results: Sixteen samples (0.9% 95% CI: 0.5–1.3%), all from 15–17-yearolds, were positive for chlamydia. Prevalence increased with age to 2% (95% CI: 0.8–3.2%) among 17 year olds and was higher among girls than boys (1.8% v. 0.1%; P < 0.001). A total of 4.6% (95% CI: 1.4–7.7%) of sexually active girls aged 17 were infected and 5/7 of them had no regular abdominal pain. Of all girls with abdominal pains, 52% had visited gynaecologists. Prevalence of infection was higher among those with pains than those without (PR = 3.8, 95% CI: 1.3–11.0). Conclusions: This is the first nationwide study based on a representative sample of boys and girls to measure chlamydia prevalence among adolescents in Germany. Prevalence in Germany is consistent with other countries. Among sexually active females, prevalence was comparable to screening thresholds. As gynaecological visits were common among females, we recommend that gynaecologists should actively offer screening to sexually active females, which would strengthen the newly implemented screening for females under 25 years.

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Chlamydia trachomatis and urogenital mycoplasms in nonconococcal urethirits in men

Medicinski pregled ◽

10.2298/mpns1002047v ◽

2010 ◽

Vol 63 (1-2) ◽

pp. 47-50

Author(s):

Sonja Vesic ◽

Jelica Vukicevic ◽

Eleonora Gvozdenovic ◽

Dusan Skiljevic ◽

Slobodanka Janosevic ◽

...

Keyword(s):

Chlamydia Trachomatis ◽

Ureaplasma Urealyticum ◽

Mycoplasma Hominis ◽

Sexually Active ◽

Transmitted Infection ◽

Sexually Transmitted ◽

Nongonococcal Urethritis ◽

Etiological Agents ◽

The One

Introduction. Nongonococcal urethritis is the most common sexually transmitted infection in men, with vast majority of the etiological agents such as Chlamydia trachomatis, followed by urogenital mycoplasmas. The aim of this study was to determine the prevalence of Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma hominis in nongonococcal urethritis in men, and to examine infections associated with these agents. Material and methods. 299 sexually active, heterosexual men with nongonococcal urethritis were included into the study. Urethral samples were taken with a dacron swab placed into the urethra up to 2-3 cm. The Direct immunojluorescence tehnique was performed for identification of Chlamydia trachomatis. Ureaplasma urealyticum and Mycoplasma hominis were detected with Mycoplasma 1ST assay. Results. Chlamydia trachomatis was detected in 22.75%, Uraeplasma urealyticum in 21.08% and Mycoplasma hominis in 8.02% cases. We found no significant differences in prevalence between Chlamydia trachomatis and Ureaplasma urealyticym (p>0.05). Monoinjections were found in 51.85% with significantly higher rate (p<0.01) than associated infections (11.70%). Among associated infections, coinfection of Chlamydia trahomatis and Ureaplasma urealyticum was predominant. Association of Chlamydia trachomatis with urogenital mycoplasmas was significantly higher (p<0.05) than the one between Ureaplasma urealyticum and Mycoplasma hominis. In 36.45% patients no patogenic microorganisms were detected. Conclusion. These results confirmed the etiological role of Chlamydia trachomatis and urogenital mycoplasmas in nongonococcal urethritis with prevalence of 51.85% in monoinfections and 11.70% in associated infections. In 36.45% of cases the etiology of urethritis was not elucidated. These results suggest that more sensitive diagnostic tool should be applied when searching for the detailed etiology of nongonococcal urethritis.

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Asymptomatic Chlamydia trachomatis Infections Among Sexually Active Men

The Journal of Infectious Diseases ◽

10.1093/infdis/154.5.900 ◽

1986 ◽

Vol 154 (5) ◽

pp. 900-903 ◽

Cited By ~ 19

Author(s):

G. H. Karam ◽

D. H. Martin ◽

T. R. Flotte ◽

F. O. Bonnarens ◽

J. R. Joseph ◽

...

Keyword(s):

Chlamydia Trachomatis ◽

Sexually Active

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Haemorrhagic Corpus Lutem Mimic Appendicitis

Bangladesh Medical Journal ◽

10.3329/bmj.v37i2.3596 ◽

1970 ◽

Vol 37 (2) ◽

pp. 66-67

Author(s):

Hasina Afroz ◽

Rabeya Akhter ◽

Shahela Jesmin

Keyword(s):

Differential Diagnosis ◽

Abdominal Pain ◽

Corpus Luteum ◽

Ovarian Tumor ◽

Rare Complication ◽

Lower Abdominal Pain ◽

Lower Abdomen ◽

Key Word ◽

Reproductive Life ◽

Chocolate Cyst

Haemoperitoneum secondary to ruptured corpus luteum is a rare complication for women of reproductive life. The differential diagnosis of hemoperitoneum includes various types of acute abdomen that usually associated with acute lower abdominal pain and swelling lower abdomen. The differential diagnosis includes ruptured ectopic pregnancy, ruptured chocolate cyst, twisted ovarian tumor, pelvic inflammatory disease and pelvic peritonitis. Ruptured hemorrhagic corpus luteum is an uncommon cause of acute abdomem. Its occurrence is unknown but is likely quite frequent and without symptoms. Most cases are self limiting; enquire only observation with abdominal pain relieved with analgesics. Some need laparoscopy or laparotomy to achieve homeostasis if the patient is haemodynamically unstable. Key word: Haemoperitoneum, Appendicitis, Ruptured Corpus luteum. DOI: 10.3329/bmj.v37i2.3596 Bangladesh Medical Journal 37(2) 2008 66-67

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Risk Factors for Chlamydia Trachomatis Infection in 6810 Young Women Attending Family Planning Clinics

International Journal of STD & AIDS ◽

10.1177/095646249200300208 ◽

1992 ◽

Vol 3 (2) ◽

pp. 117-122 ◽

Cited By ~ 18

Author(s):

Kristina Ramstedt ◽

Lars Forssman ◽

Johan Giesecke ◽

Fredrik Granath

Keyword(s):

Risk Factors ◽

Chlamydia Trachomatis ◽

Young Women ◽

Disease Spread ◽

Sexually Active ◽

Screening Criteria ◽

Chlamydia Trachomatis Infection ◽

Increased Risk ◽

History Of ◽

Culture Positive

Screening programmes are important for the control of Chlamydia trachomatis (Ct) infection, a disease spread mainly by asymptomatic carriers. Risk factors for Ct infection were assessed in 6810 consecutive asymptomatic young women seeking contraceptive advice. All women filled in a questionnaire and were offered Ct testing. Of the 5785 who consented to testing, 425 (7.3%) were Ct culture positive. Four variables were significantly related to increased risk of being infected: age 18–23 years, duration of present relationship < 1 year, non-use of condoms, and a history of not having had a previous genital infection. It is not possible to devise screening criteria that would effectively identify women at high risk. Therefore a screening programme should be targeted at all sexually active young people. However, if after some years the programme succeeds in lowering general Ct prevalence, these factors may be important when selecting patients for Ct testing.

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APPENDECTOMY IN CHILDREN WITH ACUTE RHEUMATIC FEVER

PEDIATRICS ◽

10.1542/peds.43.4.573 ◽

1969 ◽

Vol 43 (4) ◽

pp. 573-577

Author(s):

Jer-Shoung Lin ◽

Ramon Rodriguez-Torres

Keyword(s):

Differential Diagnosis ◽

Abdominal Pain ◽

Acute Appendicitis ◽

Rheumatic Fever ◽

Acute Rheumatic Fever ◽

Laboratory Data ◽

Initial Symptom ◽

C Reactive Protein ◽

Reactive Protein ◽

The Right

Clinical and laboratory data on five patients with appendectomy, later proved to have acute rheumatic fever, are presented in detail. The findings indicate that abdominal pain simulating acute appendicitis can be presented as the only initial symptom in acute rheumatic fever. Awareness and knowledge of the presence of clues-high fever, rapid sedimentation rate, prolonged P-R interval, and 4 plus C-reactive protein-usually help to make the differential diagnosis. However, if doubt remains, the right approach is to go ahead with surgery since these patients tolerate anesthesia and laparotomy very well.

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Vulvovaginitis in Premenarcheal Girls: Clinical Features and Diagnostic Evaluation

PEDIATRICS ◽

10.1542/peds.70.2.193 ◽

1982 ◽

Vol 70 (2) ◽

pp. 193-198 ◽

Cited By ~ 1

Author(s):

Jan E. Paradise ◽

Joseph M. Campos ◽

Harvey M. Friedman ◽

Gertrude Frishmuth

Keyword(s):

Chlamydia Trachomatis ◽

Trichomonas Vaginalis ◽

Vaginal Discharge ◽

Matched Control ◽

Convincing Evidence ◽

Control Group ◽

Common Cause ◽

Matched Control Group ◽

Vaginal Secretions ◽

Prepubertal Girls

Fifty-four premenarcheal patients (median age 5.8 years) with symptoms or signs of vulvovaginitis were studied, and the results of cultures of vaginal secretions were compared with those from an age-matched control group. Vaginal discharge was found on examination in 24 of 42 patients with a complaint of discharge, and in two of 12 patients without a complaint of discharge. Convincing evidence of bacterial or monilial infection was found in 14 of the 26 patients with discharge on examination, but in none of the 28 patients without discharge (P < .001). In the latter group pinworm infestation was present in one patient. Moniliasis occurred exclusively in girls who were pubertal (P < .001). Four patients were found to have gonorrhea. No patient appeared to have symptoms or signs caused by Bacteroides sp, Chlamydia trachomatis, viruses, or Trichomonas vaginalis. Noninfectious causes were identified in four patients with and 13 without discharge (P < .025); the most common cause was poor hygiene, implicated in six patients. Bubble bath use was implicated in only one patient. In 22 patients, no specific cause could be identified. All patients with poor hygiene as the only cause, and most with no demonstrable etiology, recovered after being advised to institute improved perineal hygiene. Patients with vaginal discharge are likely to have specific infections, and therefore cultures should be taken, in particular for Neisseria gonorrhoeae. Genital pruritus in prepubertal girls has little or no etiologic specificity, but in pubertal girls with vaginal discharge it suggests the presence of monilial vaginitis.

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