We performed an audit on the management of lymphogranuloma venereum (LGV) against the British Association of Sexual Health and HIV (BASHH) guidelines. Sixty-three cases of LGV were diagnosed in 60 men who have sex with men (MSM). Fifty-six out of 63 (89%) episodes were treated in accordance with the guidelines. Although all eligible patients were offered an HIV test, 10% and 29% of patients were not offered syphilis or hepatitis C tests, respectively, at the time of LGV diagnosis. Partner notification was not possible in a third of cases. Several patients were re-infected with rectal Chlamydia trachomatis in the three months following LGV diagnosis, emphasizing the importance of rescreening to detect new infections as well as treatment failures in MSM at ongoing high risk of sexually transmitted infection acquisition.
Results Among the 125 women diagnosed with acute PID, twenty two percent (n = 27) tested positive for M. genitalium, while CT, GC and bacterial vaginosis were present in 14%, 7% and 54%, respectively. Forty six women (37%) had histologic endometritis. Histologic endometritis was more common among those having cervical infections with GC, CT or MG than uninfected women (66% vs. 24%, p < 0.001). Among women with endometritis, GC, CT and MG were present in 17%, 30% and 36%, respectively. Endometritis was present in 71% (20/28) of women with endometrial GC, CT or MG. Endometrial identification of GC (100% vs. 34%, p < 0.05), CT (77% vs. 32%, p < 0.01) and MG (64% vs. 33%, p < 0.05) were each independently associated with endometritis. Conclusion Mycoplasma genitalium is identified in 22% of women diagnosed with acute PID. Similar to CT and GC, the presence of MG in the endometrium is highly associated with endometritis among women diagnosed with PID. This study suggests that M. genitalium may play an important role in the pathogenesis of PID. In this study, we analysed whether WTS and subsequent laser capture micro-dissection (LCM) with HPV PCR genotyping accurately detects type-specific HPV DNA in individual areas of high grade (HG)AIN. Methods 31 WTS with HGAIN of 21 HIV+ MSM were analysed by the SPF10 PCR/LiPA25 (version 1) HPV genotyping system. In case of multiple HPV types, PCR was repeated in selected areas of AIN, isolated by LCM. Results WTS PCR showed a single HPV type in 17 (55%). In the remaining 14 WTS sections with multiple HPV types, PCR was repeated in LCM-isolated dysplastic areas (median: 4 per WTS). In 12 of 14 these samples, the number of HPV types could be reduced to single HPV types within discrete areas of a lesion, resulting in a total of 29 (17+12), in which (components of) HGAIN show a singe HPV type. HPV 16 was found in 14/29 (48%), HPV 18 in 3 and HPV 58 in 3. The remaining HPV types that could be linked to a lesional area were HPV 26, 31, 35, 39, 52, 53, 54, 59, 67, 68/73, 74, 91 Background The epidemiology of neonatal herpes infection (nHSV) is changing as herpes simplex virus type 1 (HSV-1) is an increasingly common cause of genital herpes. Few sources of population-based data for nHSV exist; nHSV has been a notifiable disease in New York City (NYC) since 2006. Methods To compare the clinical and demographic characteristics of nHSV due to HSV-1 and herpes simplex virus type 2 (HSV-2), we used standard case investigation forms to abstract infant inpatient/ outpatient medical records, and maternal labour and delivery records for babies ≤ 60 days of age diagnosed with laboratory-confirmed herpes infection and reported in NYC during 2006-2012. Disease syndromes were grouped as invasive (disseminated/central nervous system infection/death) versus localised (skin/eye/mucous membrane infection,). Cases lacking liver function test results, or lumbar puncture were excluded from analyses of disease syndrome. Bivariate analyses compared clinical and demographic characteristics by viral type. Re...
Patients diagnosed with lymphogranuloma venereum have high rates of co-infection with HIV, syphilis and hepatitis C. The aim of this enhanced surveillance was to screen all men who have sex with men (MSM) newly diagnosed with HIV, syphilis or hepatitis C for co-infection with asymptomatic lymphogranuloma venereum as part of the recommended sexual health screen. Of the 145 patients screened, 21 patients were diagnosed with rectal Chlamydia trachomatis, one with both rectal and urethral chlamydia and six with urethral chlamydia. One rectal chlamydia-positive sample, when tested, was equivocal for lymphogranuloma venereum. Our data suggested that there was not a pool of asymptomatic lymphogranuloma venereum infection in MSM recently diagnosed with HIV, hepatitis C and syphilis. However, there have been recent reports of an increased incidence of asymptomatic lymphogranuloma venereum, raising the question whether lymphogranuloma venereum should be screened for in high risk asymptomatic MSM. The prevalence of asymptomatic rectal chlamydia infections was 19%.
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