11/146. Watering can perineum--a forgotten complication of gonorrhoea.In the modern era of broad spectrum antibiotics, urethral fistulae (watering can perineum) is one of the forgotten sequelae of chronic gonococcal infection. We report a 20-year-old unmarried male with gonococcal urethritis and two sinuses in the scrotum (watering can perineum). The micturating and retrograde urethrogram revealed mucosal irregularity and extravasation of contrast medium at the junction of bulbous and membranous urethra. Recent worldwide emergence of multidrug resistant strains of gonococci give rise to alarm. In the present scenario of hiv pandemic, ineffective treatment of patient or partner with gonorrhoea may result in development of these complications.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
12/146. Value of the erythrocyte sedimentation rate in gynecologic infections.The ESR remains a valuable test in gynecology, specifically when obtained sequentially in cases of pelvic infection. It is nonspecific but has much merit in assessing prognosis and therapeutic measures. In conjunction with laparoscopy and diagnostic ultrasound it plays an important part in the evaluation of abdominal and pelvic infections.- - - - - - - - - - ranking = 6keywords = infection (Clic here for more details about this article) |
13/146. Disseminated gonococcemia.A 26-year-old woman presented with a high-grade fever and chills of 2 days' duration. She complained of associated joint pain, especially in the wrists and knees. One day before admission, tender skin lesions began to develop on the fingers, and subsequently spread to the more proximal extremities. The patient recalled having a sore throat and a nonproductive cough before the onset of the fever and eruption. The past medical history was significant for gardnerella vaginitis and several urinary tract infections. The patient was taking oral contraceptive pills; her most recent menstruation was 3 weeks before admission. She reported having sexual intercourse with her boyfriend 2 weeks before admission. The patient's temperature was 40 degrees C. Dermatologic examination revealed a 6-mm, hemorrhagic pustule on an ill-defined pink base, overlying the volar aspect of the left second proximal interphalangeal joint (Fig. 1a). Scattered on the upper and lower extremities were occasional round, ill-defined pink macules with central pinpoint vesiculation (Fig. 1b). A skin biopsy of the digit revealed a dense neutrophilic infiltrate with leukocytoclasis and marked fibrin deposition in the superficial and deep dermal vessels (Fig. 2a). Gram stains demonstrated the presence of Gram-negative diplococci (Fig. 2b). Laboratory findings included leukocytosis (leukocyte count of 20 x 109/L, with 81% neutrophils). Analysis of an endocervical specimen by polymerase chain reaction was positive for neisseria gonorrhoeae and negative for chlamydia trachomatis. Throat and blood cultures grew N. gonorrhoeae. Specimen cultures obtained by skin biopsy yielded no growth. Results of serologic analysis for human immunodeficiency virus, hepatitis, syphilis, and pregnancy were negative. Beginning on admission, intravenous ceftriaxone, 2 g, was administered every 24 h for 6 days, followed by oral cefixime, 400 mg twice daily for 4 days. Oral azithromycin, 1 g, was administered to treat possible coinfection with C. trachomatis. By treatment day 4, the patient was afebrile, with the resolution of leukocytosis and symptomatic improvement of arthralgias.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
14/146. Perianal abscess due to neisseria gonorrhoeae: an unusual case in the post-antibiotic era.Described here is the case of a 21-year-old homosexual male patient who presented with perianal abscess without urethritis that was caused by infection with neisseria gonorrhoeae. Incision and drainage of the abscess and oral penicillin therapy resulted in full healing, without the development of an anal fistula. The spectrum of gonococcal abscesses and the relevant aspects of their management are discussed.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
15/146. Fulminant endocarditis due to infection with penicillinase-producing neisseria gonorrhoeae.endocarditis is a rare but potentially lethal manifestation of gonococcal infection. We report the case of a patient with fulminant endocarditis secondary to infection with penicillinase-producing neisseria gonorrhoeae (PPNG). The patient had rapid deterioration from extensive destruction of the aortic valve with abscess and fistula formation. Lifesaving emergency surgery was performed. To our knowledge this is the first reported case of gonococcal endocarditis secondary to infection with a penicillinase-producing organism.- - - - - - - - - - ranking = 7keywords = infection (Clic here for more details about this article) |
16/146. Therapeutic regimens for anorectal gonococcal infection in males.Anorectal gonococcal infection is particularly prevalent in women and homosexual men. Although the currently recommended public health Service therapeutic regimens for uncomplicated gonorrhea appear to be effective also for anorectal gonorrhea in women, their efficacy for anorectal infection in men has not been adequately evaluated. We report a case of gonococcal proctitis in a homosexual man that did not respond to therapy with ampicillin plus probenecid and tetracycline, but subsequently responded to spectinomycin therapy. Currently available therapeutic regimens for anorectal gonococcal infection in males are reviewed.- - - - - - - - - - ranking = 7keywords = infection (Clic here for more details about this article) |
17/146. Gonococcal tonsillar infection--a case report and literature review.Oral gonococcal infection is an uncommon but well-described manifestation of gonococcal infection, usually described as pharyngitis in the literature. tonsillitis is much rarer and its role in the clinical presentation in oral gonorrhea is less clear. We describe a case of oral gonorrhea presenting with tonsillitis and a discrete cervical lymphadenopathy and present a review of the literature from 1961 to 2002. Of the 512 reported cases of oral gonococcal infection, only 61 have been described to be tonsillitis. The tonsils were invariably enlarged and infected. A whitish-yellow exudate in the cryptae was described in 12 cases (20.6%). fever and cervical lymphadenopathy appear to be rather uncommon, since they have been described in only five (8.2%) and six (9.3%) of the 61 patients with tonsillitis, respectively. Gonococcal tonsillitis should be included in the differential diagnosis of tonsillitis in sexually active patients.- - - - - - - - - - ranking = 7keywords = infection (Clic here for more details about this article) |
18/146. An unusual cause of an epidural abscess.A previously well 30-year-old man presented with severe progressive back pain, joint pain and fever. magnetic resonance imaging confirmed an epidural abscess. A sexual history revealed both risk factors for and previous symptoms of a sexually acquired infection. neisseria gonorrhoeae was isolated from a rectal swab and from a wrist aspirate, consistent with disseminated gonococcal infection. The epidural abscess resolved clinically and radiologically after treatment for N. gonorrhoeae with ceftriaxone.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
19/146. Acute gonococcal flexor tenosynovitis in an adolescent male with pharyngitis. A case report and literature review.A 15-year-old boy had acute gonococcal flexor tenosynovitis of the middle finger associated with symptomatic gonococcal pharyngitis. The patient had a history of blunt trauma to the hand. The need for a careful history in any sexually active adolescent is emphasized. Acute flexor tenosynovitis may be the only manifestation of disseminated gonococcal infection.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
20/146. Multiple sexually acquired diseases occurring concurrently in an hiv positive man: case report, diagnosis and management.A case of an hiv positive man with multiple sexually acquired disease occurring concurrently is described. Risk behaviours that could have predisposed him to hiv infection are discussed. The factors which might have interacted to make the sexually acquired infections severe and difficult to treat are postulated.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
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