1/85. Laser ablation of urethral hair. BACKGROUND AND OBJECTIVE: Two separate cases involving laser ablation of hair follicles in the neourethra are described. STUDY DESIGN/MATERIALS AND methods: Urethral hair developed secondarily to free-flap urethroplasty for congenital urethral defects. In both cases, cystoscopic depilation with electrocautery fulguration was attempted on multiple occasions. RESULTS: No improvement was seen; therefore, laser ablation was employed. Both patients remain free of regrowth at greater than one year of follow-up. ( info) |
2/85. 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. ( info) |
3/85. 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. ( info) |
| INTRODUCTION: female urethral adenocarcinoma is extremely rare and more than one tissue of origin has been suggested other than the Skene's gland. immunohistochemistry with cytokeratins (CK) 7 and 20 is used to define the origin of the tumor. CASE REPORT: A 72-year-old woman presented with a 2-cm polypoid tumor at the external urethral meatus and bleeding. Wide local excision and bilateral inguinal lymphadenectomy were performed. Postoperative convalescence was uneventful. It was a poorly differentiated mucinous adenocarcinoma without direct urothelial involvement. There were focal areas of intestinal metaplasia. The tumor cells were positive for CK 7 and 20 and negative for prostate-specific antigen. DISCUSSION: This case provides supportive evidence that mucinous urethral adenocarcinoma may arise from malignant transformation of urethritis glandularis. ( info) |
| BACKGROUND AND OBJECTIVES: The Cuban Ministry of public health plans to implement the syndromic approach to sexually transmitted diseases in persons with urethral or vaginal syndrome in cuba using 500 mg ciprofloxacin as therapy. Although the emergence of clinical isolates of neisseria gonorrhoeae with decreased susceptibility to ciprofloxacin have been sporadically detected in cuba, there has been no report of isolates that exhibited significant resistance to this drug. This is the first report of the isolation of a N gonorrhoeae strain resistant to ciprofloxacin in cuba. STUDY DESIGN: Case report. CONCLUSIONS: This case emphasizes the need for awareness regarding the potential emergence of a clinically significant resistance of N gonorrhoeae in cuba. There is a need for continued antimicrobial susceptibility surveillance of Cuban isolates to ciprofloxacin and other fluoroquinolones. ( info) |
| The case is reported of a man with schistosomiasis of the bladder which gave rise to non-gonococcal urethritis. diagnosis was confirmed by finding the characteristic terminal-spined schistosoma haematobium ova in the urine deposit. The cystoscopic appearances further confirmed the disease and its stage. The patient responded satisfactorily to treatment although the follow-up period was short. ( info) |
7/85. 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. ( info) |
8/85. 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. ( info) |
9/85. urethritis: an underestimated clinical variant of genital herpes in men? Two men had a first clinical episode of genital herpes presenting as nongonococcal urethritis in the absence of any penile lesions. Data on the etiologic function of herpes simplex in patients with nongonococcal urethritis are scarce and conflicting. Considering our cases, the large amount of nongonococcal urethritis of unknown origin, and the high frequency of unrecognized genital herpes, herpes simplex virus may be a significant etiologic agent of nongonococcal urethritis and warrants necessary laboratory investigations in patients with clear mucoid urethral discharge. ( info) |
| Three cases of primary adenocarcinoma of the female urethra are presented. The tumour in the first case was associated with urethritis glandularis and is thought to arise from previous glandular metaplasia of the urethral mucosa. The tumour in the second case resembled the clear-cell carcinomas of the lower female genital tract and is thought to be of embryonic rest origin. The tumour in the third case is thought to arise from the paraurethral glands. ( info) |