scholarly journals Case Series of Three Patients with Disseminated Gonococcal Infection and Endocarditis

2021 ◽  
Vol 5 (4) ◽  
pp. 381-384
Author(s):  
Phillip Moschella ◽  
Hannah Shull ◽  
Mark Pittman ◽  
Alex Gleason ◽  
Prerana Roth
Keyword(s):  
Differential Diagnosis ◽  
Sexually Transmitted Infections ◽  
Case Series ◽  
Warning Sign ◽  
Gonococcal Infection ◽  
Sexually Transmitted ◽  
Resistance Patterns ◽  
History Of ◽  
Antibiotic Resistance Patterns ◽  
Urine Testing

Introduction: The increasing incidence of Neisseria gonorrhoeae infections and emergence of cephalosporin-resistant strains means the threat of disseminated gonococcal infection and endocarditis needs to be reimagined into the differential diagnosis for patients treated in the emergency department (ED) for sexually transmitted infections and for endocarditis itself. Only 70 cases of disseminated gonococcal infection (DGI) with endocarditis had been reported through 2014.1-4 In 2019, however, an outbreak of DGI with one case of endocarditis was reported.5 This case series of three patients with DGI and endocarditis, in addition to the recent outbreak, may represent a warning sign for reemergence of this threat. Case Report: We describe three cases within a recent three-year period of gonococcal endocarditis as seen and treated at our institution. These cases show divergent presentations of this insidious disease with both classical and atypical features. One case displayed a classic migratory rash with positive urine testing and a remote history of sexually transmitted infections, while another patient developed isolated culture-confirmed endocarditis with negative cervical testing and imaging, and the final case was a male patient who presented to the ED with fulminant endocarditis as the first ED presentation of infection. Conclusion: Secondary to an overall rise in incidence and possibly due to increasing antibiotic-resistance patterns, gonococcal endocarditis should be included in the differential diagnosis of any case of endocarditis. Reciprocally, increased vigilance should surround the evaluation of any patient for sexually transmitted diseases while in the ED for both the development of DGI and endocarditis.

scholarly journals Childhood Pilomatrixoma: Case Series from a Single Center

2020 ◽  
Author(s):  
Begümhan Demir Gündoğan ◽  
Fatih Sağcan ◽  
Mehmet Alakaya ◽  
Ferah Tuncel Daloğlu ◽  
Elvan Çağlar Çıtak
Keyword(s):  
Differential Diagnosis ◽  
Medical Records ◽  
Clinical Presentation ◽  
Case Series ◽  
Neck Region ◽  
Head And Neck Region ◽  
Common Causes ◽  
Institutional Experience ◽  
History Of ◽  
Associated Conditions

INTRODUCTION: The aim of this study is to describe our institutional experience with pilomatrixoma in children, specifically examining its clinical presentation, associated conditions, radiological and pathological findings and attract attention to differential diagnosis for this tumor. METHODS: The medical records of 52 patients were reviewed retrospectively. RESULTS: There were a total of 62 tumors in 52 children. The median age at excision was 9.5 years old. Tumors were predominantly located in head and neck region (48.4%). One patient had a family history of pilomatrixoma. One patient had Turner Syndrome and one had Tuberous Sclerosis complex. Fifty-four lesions were examined by ultrasonography (USG). Pilomatrixoma was considered in the differential diagnosis in eight patients (15.3%) by a radiologist. DISCUSSION AND CONCLUSION: Pilomatrixoma is one of the most common causes of superficial masses in children. It should be kept in mind for differential diagnosis in children with superficial masses.

scholarly journals Sexual Behaviors and Sexually Transmitted Infections Among Male Veterans and Nonveterans

2017 ◽  
Vol 11 (4) ◽  
pp. 791-800 ◽  
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.

scholarly journals Fetal Macrocephaly: A Novel Sonographic Finding in Congenital Myotonic Dystrophy

2020 ◽  
Vol 10 (03) ◽  
pp. e294-e299
Author(s):  
Shiri Shinar ◽  
Parry Balakumar ◽  
Vibhuti Shah ◽  
Karen Chong ◽  
Tami Uster ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Myotonic Dystrophy ◽  
Case Series ◽  
Single Center ◽  
Third Trimester ◽  
Biparietal Diameter ◽  
Congenital Myotonic Dystrophy ◽  
Appropriate For Gestational Age ◽  
History Of ◽  
The Mean

Abstract Objective Sonographic clues to the diagnosis of congenital myotonic dystrophy (CDM) are limited, particularly in the absence of family history of myotonic dystrophy (DM). We reviewed cases of CDM for unique prenatal findings. Study Design A single-center case series of fetuses with CMD with characteristic prenatal findings confirmed postnatally. Results Four fetuses with pre- or postnatally diagnosed CDM presented with macrocephaly in utero. While head measurements were appropriate for gestational age until midgestation, third-trimester head circumference and biparietal diameter were both >2 standard deviation (SD) above the mean in all. Abdominal and femur measurements were otherwise appropriate for gestation. Postnatally, the occipitofrontal circumference was >2 SD above the mean in all, confirming the diagnosis of macrocephaly. Conclusion CDM should be included in the differential diagnosis of third-trimester macrocephaly, especially in the presence of additional sonographic clues and when maternal medical history and physical examination are suggestive of DM.

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

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.

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

2006 ◽  
Vol 2006 ◽  
pp. 1-3 ◽  
Author(s):  
Charles J. Rolle ◽  
Clifford Y. Wai ◽  
Roger Bawdon ◽  
Rigoberto Santos-Ramos ◽  
Barbara Hoffman
Keyword(s):  
Ectopic Pregnancy ◽  
Sexually Transmitted Infections ◽  
Fallopian Tube ◽  
Lower Abdominal Pain ◽  
Rare Condition ◽  
Operative Trauma ◽  
Sexually Transmitted ◽  
Uncommon Presentation ◽  
Increased Risk ◽  
History Of

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.

scholarly journals Sexual behaviour and infection rates for HIV, blood-borne and sexually transmitted infections among patients attending drug treatment centres in Rio de Janeiro, Brazil

2000 ◽  
Vol 11 (6) ◽  
pp. 383-392 ◽  
Author(s):  
F I Bastos ◽  
C M Lowndes ◽  
M Derrico ◽  
L R Castello-Branco ◽  
M I Linhares-De-Carvalho ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Hepatitis B ◽  
Sexually Transmitted Infections ◽  
Odds Ratio ◽  
Rio De Janeiro ◽  
Drug Users ◽  
Hepatitis C Infection ◽  
Sexually Transmitted ◽  
History Of ◽  
Independent Risk Factors

A survey was carried out in 2 drug use treatment centres (TCs) in Rio de Janeiro, Brazil, to assess risk behaviours, HIV infection and other sexually transmitted infections/blood-borne infections (STIs/BBIs). Two hundred and twenty-five drug users (195 males and 30 females) were interviewed and clinically examined, and their blood and urine were tested for STIs/BBIs. Prevalences (%) for these infections were as follows - HIV: 0.9, hepatitis B virus (HBV): 14.7, hepatitis C virus (HCV): 5.8, syphilis: 5.3, gonorrhoea/chlamydia (CT/NG): 4.7. In bivariate analyses CT/NG infection was associated with younger age ( P =0.003); current genitourinary symptoms (odds ratio [OR]=6.2) and a mainly illegal source of income (OR= 9.1). Hepatitis C infection was associated with a history of ever having injected any drug (OR=19.6), and with each one of the injected drugs. After multiple logistic regression, lower educational level (adjusted odds ratio [AOR]=3.70) and 'ever having injected drugs' (AOR=3.69) remained as independent risk factors for hepatitis B infection. In conclusion, TCs must implement programmes directed towards the prevention of STIs/BBIs.

Antibiotic Chemotherapy of Bacterial Sexually Transmitted Diseases in Adults: A Review

1994 ◽  
Vol 5 (3) ◽  
pp. 165-171 ◽  
Author(s):  
Gerard D Corcoran ◽  
Geoffrey L Ridgway
Keyword(s):  
Natural History ◽  
Gonococcal Infection ◽  
New Agents ◽  
Treatment Protocols ◽  
Sexually Transmitted ◽  
Treatment Regimens ◽  
Quinolone Antibiotics ◽  
History Of ◽  
Treatment Policies ◽  
Antibiotic Courses

Treatment regimens for sexually transmitted infections continue to evolve. The natural history of syphilis in HIV-infected patients is leading to more aggressive policies in terms of both investigation and treatment. In particular, treatment protocols for late syphilis, especially neurosyphilis, are under scrutiny. Epidemiological change typified by the spread of penicillinase-producing Neisseria gonorrhoeae (PPNG) has led to a search for new agents to treat gonorrhoea, with a more extensive use of cephalosporin and quinolone antibiotics emerging. The problem of compliance with the antibiotic courses presently required for chlamydial infection may be close to being solved with the development of newer macrolide agents. Single dose azithromycin, although expensive, seems to be as effective as longer courses with other agents. Furthermore, its efficacy in gonococcal infection is also encouraging. Increased understanding of the pathogenesis and natural history of pelvic inflammatory disease (PID) and bacterial vaginosis (BV) has led to rationalization of treatment policies for these conditions.

scholarly journals Prevalence of sexually transmitted infections and bacterial vaginosis among lesbian women: systematic review and recommendations to improve care

2019 ◽  
Vol 35 (3) ◽  
Author(s):  
Maira Libertad Soligo Takemoto ◽  
Mariane de Oliveira Menezes ◽  
Carla Betina Andreucci Polido ◽  
Débora de Souza Santos ◽  
Valeria Marli Leonello ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bacterial Vaginosis ◽  
Sexually Transmitted Infections ◽  
Lesbian Women ◽  
Care Providers ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Sexual Stigma ◽  
Wide Range ◽  
History Of

Our aim was to systematically review data about the risk of sexually transmitted infections (STI) and bacterial vaginosis among lesbian women and to suggest strategies to improve prevention, diagnosis and treatment. A search strategy for lesbian, STI and bacterial vaginosis was applied to PubMed, LILACS and BDENF databases. Of 387 unique references retrieved, 22 fulfilled the inclusion criteria (cross-sectional studies reporting prevalence for 8 STIs/bacterial vaginosis and history of a STI). The most frequent infection reported was bacterial vaginosis, and none study reported data on hepatitis B. A wide range of prevalence was observed for most infections. In terms of risk factors, the number of sexual partners, the past or current smoking, a history of forced sex and sexual stigma seem to increase the risk of STI and bacterial vaginosis. The findings of this review are discussed considering guidelines directly addressing the LGBT community’s health and relevant studies investigating both safe sexual practices and the intricate relationship between LGBT people and their care providers. A set of recommendations to improve preventive care for lesbian women is proposed. Affirming that little is known about the extent of STIs and bacterial vaginosis transmission in female-to-female sexual activities or about the risk factors for STI and bacterial vaginosis among lesbian women is reasonable. In fact, the overall quality of the studies was low or very low with significant uncertainty around their findings. However, we consider that the available knowledge indicates some paths to be followed by care providers and policy decision-makers to improve their actions towards better sexual health of lesbian women.

HIV infection and asymptomatic sexually transmitted infections in a rural South African community

1998 ◽  
Vol 9 (9) ◽  
pp. 548-550 ◽  
Author(s):  
M Colvin ◽  
S S Abdool Karim ◽  
C Connolly ◽  
A A Hoosen ◽  
N Ntuli
Keyword(s):  
Hiv Infection ◽  
Sexually Transmitted Infections ◽  
South African ◽  
Treponema Pallidum ◽  
Population Based ◽  
Sexual Practices ◽  
Sexually Transmitted ◽  
History Of ◽  
African Community ◽  
Partner Concurrency

The objective was to determine the prevalence of HIV and other sexually transmitted infections STIs in a rural community. A population based survey of adults in 110 homesteads was conducted in 1995. A questionnaire on demographics, sexual practices and history of STDs was administered. Neisseria gonorrhoeae and Chlamydia trachomatis infections were detected using ligase chain reaction LCR assay of urine. The seroprevalence of syphilis rapid plasma reagin RPR and Treponema pallidum haemagglutination assay TPHA and HIV infection ELISA was determined. Among 259 subjects the prevalence of HIV was 10.5 , N. gonorrhoeae 4.5 , C. trachomatis 6.1 and active syphilis 8.8 . All infections were asymptomatic. Forty per cent of sexually active men had more than one concurrent sexual partner. Only 14 of subjects had ever used condoms. The STI epidemic is being promoted by high levels of asymptomatic infections, high partner concurrency and low condom use.

scholarly journals Association of Risk Factors With Hepatitis B & C Infection Among Pregnant Women Visiting a Private Tertiary Care Hospitals- Peshawar (An Un Matched Pilot Case Control Study)

2020 ◽  
Author(s):  
Jalwa Javed Farooqi ◽  
Farhat Rehana Malik ◽  
Kanza Javed Farooqi ◽  
Owais Mudassar
Keyword(s):  
Risk Factors ◽  
Hepatitis B ◽  
Pregnant Women ◽  
Sexually Transmitted Infections ◽  
Past History ◽  
Tertiary Care ◽  
Case Control ◽  
Sexually Transmitted ◽  
History Of ◽  
Tertiary Care Hospitals

Abstract Background; Viral hepatitis causes devastating health issues to everyone globally and specifically the most vulnerable groups like pregnant ladies. The aim of this study was to identify risk factors for hepatitis B and C virus infection with univariate association of virus seropositivity among pregnant women and comparison of public with private hospital data.Study Design; An Unmatched Case Control Pilot Study.Place and Duration; Gynaecology wards of Two Public Tertiary Care Hospitals of Peshawar and equal number of Private clinics, from September- 2018 to February- 2019.Methods; This study enrolled 21 cases and controls as 1:1 ratio via consecutive sampling. A validated questionnaire was used. Cases included were HBsAg and ELISA positive HCV females, while anti HBsAg and Anti HCV ELISA negative were the controls. The collected data was entered and analysed in SPSS version- 19. Descriptive statistics were computed by frequency and percentages while inferential statistics through Odd ratio and 95% confidence interval. P value cut of limit was set at <0.05. Results; The mean age was 37±9 for the cases and 28±6 years for controls respectively. The risk factors with increase occurrence of disease were past history of abortion OR=1.23 (95% Cl=0.34-4.35), past hospitalization OR=2.90 (Cl=0.77-10.8), past surgical procedure OR=3.69 (Cl=0.81-16.6), dental extraction OR=1.25 (Cl=0.33-4.63), delivery in hospital OR=4.26 (Cl=1.13-16.05), injection in hospitals OR=1.47 (Cl=0.43-5.04), household contact with jaundice OR=5.66 (Cl=1.41-22.7). Normal vaginal delivery OR=1.96 (Cl=0.51-7.48) and history of sexually transmitted infections OR=2.23 (Cl=0.36-13.7) were independently associated with HBV, HCV.Conclusion; Iatrogenic exposures of injections, blood transfusions, tooth extractions, home deliveries with past history of sexually transmitted infections, abortion, hepatitis infection and hospital admissions were the risk factors among the pregnant women.

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