1/28. Multiple drug-resistant chlamydia trachomatis associated with clinical treatment failure.in vitro susceptibility testing and genotyping were done on urogenital isolates of chlamydia trachomatis from 3 patients, 2 of whom showed evidence of clinical treatment failure with azithromycin and one of whom was the wife of a patient. All 3 isolates demonstrated multidrug resistance to doxycycline, azithromycin, and ofloxacin at concentrations >4.0 microg/mL. Recurrent disease due to relapsing infection with the same resistant isolate was documented on the basis of identical genotypes of both organisms. This first report of clinically significant multidrug-resistant C. trachomatis causing relapsing or persistent infection may portend an emerging problem to clinicians and public health officials.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
2/28. Adenovirus and non-gonococcal urethritis.Non-gonococcal urethritis (NGU) is a common problem presenting to sexual health clinics that is usually managed empirically. In many cases the aetiology is never clearly established or further investigated. Adenovirus has been identified in the past as an occasional cause of NGU but little has been written about its clinical presentation. We present a case report of 6 men who were diagnosed with NGU caused by adenovirus infection, along with a review of the relevant literature, with the aim of improving clinical recognition of this pathogen.- - - - - - - - - - ranking = 0.5keywords = infection (Clic here for more details about this article) |
3/28. Emergence of cephem- and aztreonam-high-resistant neisseria gonorrhoeae that does not produce beta-lactamase.Regarding neisseria gonorrhoeae, the National Committee for Clinical Laboratory Standards (NCCLS) has not defined the breakpoint minimum inhibitory concentration (MIC) for expanded spectrum cephems such as cefpodoxime and ceftizoxime, because of the absence of resistant strains to these antibiotics. To date, in gonococcal urethritis, after treatment with third generation cephems and aztreonam, clinical failures caused by resistant N. gonorrhoeae strains have not been reported. However, we experienced two clinical failures in patients with gonococcal urethritis treated with cefdinir and aztreonam. N. gonorrhoeae isolates from these two patients showed high-level MICs to these agents. The MIC of cefdinir was 1 microg/ml for both strains and that of aztreonam was 8 microg/ml for both strains, while the MICs of other beta-lactams were also higher than the NCCLS value, except for ceftriaxone, for which the MIC was 0.125 microg/ml for both strains. Moreover, the MICs of fluoroquinolones, tetracyclines, and erythromycin against these two isolates were higher than the NCCLS susceptibility value. These isolates were susceptible to spectinomycin. In N. gonorrhoeae, the emergence of these beta-lactam-resistant isolates is of serious concern. However, a more serious problem is that these isolates were already resistant to non-beta-lactam antimicrobials. In japan, ceftriaxone has not been permitted for clinical use against gonococcal infections. Therefore, in japan, patients with gonococcal urethritis caused by these resistant N. gonorrhoeae strains should be treated with cefodizime or spectinomycin.- - - - - - - - - - ranking = 0.5keywords = infection (Clic here for more details about this article) |
4/28. Simultaneous scabies and gonococcal infection.A case is presented of an unusual complication arising in a man with scabies and gonococcal urethritis: the secondary infection of excoriated genital lesions by neisseria gonorrhoeae. This occurred after he had occluded his genitals with a plastic wrap.- - - - - - - - - - ranking = 2.5keywords = infection (Clic here for more details about this article) |
5/28. 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 = 0.5keywords = infection (Clic here for more details about this article) |
6/28. Acute urethritis and arthritis-dermatitis syndrome due to neisseria meningitidis.Acute urethritis and arthritis-dermatitis syndrome after sexual contact are often assumed to be caused by neisseria gonorrhoeae. We report a case of arthritis-dermatitis syndrome in a 32-year-old man who presented with generalized maculopapular and petechial skin lesions and polyarthritis. Acute urethritis developed 1 week after oro-genital sexual contact with a sex worker about 3 weeks before admission. No pathogen was found on smear of urethral discharge and skin lesions, but Gram-negative diplococci were noted in joint fluid, and blood culture yielded N. meningitidis. His condition improved gradually after repeated arthrocentesis and antibiotic therapy with ceftriaxone followed by ciprofloxacin. Oro-genital contact is a transmission route for N. meningitidis infection manifesting as acute urethritis and arthritis-dermatitis syndrome.- - - - - - - - - - ranking = 0.5keywords = infection (Clic here for more details about this article) |
7/28. Orogenital transmission of neisseria meningitidis serogroup C confirmed by genotyping techniques.urethritis caused by neisseria meningitidis in heterosexual patients is presumed to occur via orogenital contact, but confirmation has not been possible in most cases. Presented here is a case of urethritis caused by N. meningitidis, serogroup C, and the isolation of the same microorganism from the nasopharynx and endocervix of the patient's sexual partner. The similarity of the urethral and nasopharyngeal isolates' electrophoretic patterns, obtained using pulsed-field gel electrophoresis, proves the infection was transmitted via orogenital contact.- - - - - - - - - - ranking = 0.5keywords = infection (Clic here for more details about this article) |
8/28. Chlamydial seminal vesiculitis without symptomatic urethritis and epididymitis.We previously reported that seminal vesiculitis was associated with acute epididymitis, and that chlamydia trachomatis was the major causative pathogen for infection of the seminal vesicle, suggesting that seminal vesiculitis was a discrete disease entity. In this paper, we report two patients with bacteriologically and cytologically proven seminal vesiculitis who had asymptomatic urethritis but not epididymitis. The clinical courses of these patients suggest that chlamydial seminal vesiculitis may be a cause of asymptomatic infection of the urethra or subsequent development of acute epididymitis.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
9/28. Can chlamydial conjunctivitis result from direct ejaculation into the eye?The majority of cases of chlamydial conjunctivitis are thought to result from autoinoculation by the patient of infected genital secretions from themselves or their sexual partners. We noted that some patients had developed symptoms following direct ejaculation into the affected eye. We describe four cases of chlamydial conjunctivitis following ejaculation of semen directly into the eye, which have not been previously described. In only one case was chlamydia detected in the genital tract. In three cases, there was no evidence of genital chlamydial infection; the sources of the eye infection being either from infected genital material of their sexual partners transferred by hands to the eyes, or more likely from direct ejaculate inoculation. It is likely that this mode of transmission is underestimated as a history of ejaculation into the conjunctiva is not normally asked for.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
10/28. Meningococcal urethritis.Two to four percent of the population carry meningococcus in the nasopharynx. Pharyngeal infections may be the entry point for blood-borne metastatic lesions throughout the body. Primary infections in other tissues are rare, and proof of transmission from a known carrier to a specific patient is uncommon. We report a primary infection of the urethra with the meningococcus in a heterosexual male contracted during an act of fellatio.- - - - - - - - - - ranking = 1.5keywords = infection (Clic here for more details about this article) |
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