Genitorectal trichomonas invasion as (co)-factor in pathogenesis of Behcet's syndrome

Behcet’s disease: from heat shock proteins to infections

Background: Behcet’s disease (BD) is a chronic, inflammatory multisystemic condition of unknown etiology. Although the cause of BD is not clear, it is believed to be the result of an autoimmune process triggered by an infectious or environmental agent (possibly local to a geographic region) in a genetically predisposed individual.

Objective: To detail current knowledge of the role of microorganisms in the pathogenesis of BD and review the infectious etiology of this disease.

Methods: The review based on publication in SCOPUS, Science direct, and PubMed.

Results: A microbial infection has been implicated in the development of the disease to explain the strong inflammatory reactions observed, the activation of monocytes and macrophages, and the induction of proinflammatory cytokines and chemokines detected. Common factors linking some of the possible pathogenetic agents are extrinsically induced tissue stress or heat shock proteins, which react with host tissues and elicit significant T-helper type 1 cell responses.

Conclusion: Based on collected data, we conclude that the microorganisms discussed seem to participate and, at least in part, act as triggers during the course of BD. By clarifying the microbial associations of BD and finding its etiology, particularly the causative antigens leading to BD, it would be easier to suggest more effective treatment and preventive strategies for this disease.

Trichomonas vaginalis Associated with Chronic Penile Ulcers and Multiple Urethral Fistulas

The case of a 29-year-old, HIV-infected man presenting with Trichomonas vaginalis (TV)-associated chronic penile ulcers and multiple urethral fistulas is described. To our knowledge, this is the first description of chronic TV infection being implicated as the probable cause of a destructive lesion leading to sinus drainage and fistula formation.

Rectovaginal fistula following low circular stapled anastomosis in women with rectal cancer

Low anastomosis using a circular stapling instrument has become standard for performing a colorectal reconstruction following resection of a rectal cancer. Often these anastomoses are performed deep in the pelvis using a circular stapling instrument without clear visualization of the anastomotic site. In the female patient, unless an adequate stump of rectum is left above the circular staple line, there is danger that the side wall of the posterior aspect of the vagina can be included in the tissue rings (donuts) that are resected by the circular stapling instrument. This leaves the patient at high risk for late development of a rectovaginal fistula by vaginal mucosa being incorporated into the rectal wall. Maintenance of an adequate mucosa beyond the linear staple linen and a vaginal examination prior to firing the circular stapler will prevent this problem. A patient is presented and the technical details for a safe low-low colorectal anastomosis are reviewed.

Pre-existing chronic infraepithelial Trichomonas invasion with consecutive immunodepression enables progression of human immunodeficiency virus: a new concept of acquired immunodeficiency syndrome pathogenesis

All three existing species of human trichomonads cause similar immune and histopathological host responses. The elicited crossimmunity causes interspecific competition of trichomonal infections in their typical localizations, which results in very rare simultaneous colonization of the same host by different species. This phenomenon points to the existence of a unique immune disorder or subclinical sensitization, regardless of which trichomonas species is in question. The total percentage of infestations in all three species points to the most widespread parasitosis, i.e. the immunodepression of human beings. Trichomonaemia has a very strong immunodepressive action. All the other agents, including viruses act only as opportunists.