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Chromy D, Sadoghi B, Gasslitter I, Skocic M, Okoro A, Grabmeier-Pfistershammer K, Willinger B, Weninger W, Öllinger A, Sarcletti M, Stary G, Bauer WM. Lymphogranuloma venereum verläuft häufig asymptomatisch bei Männern, die Sex mit Männern haben, in Österreich. J Dtsch Dermatol Ges 2024; 22:389-398. [PMID: 38450885 DOI: 10.1111/ddg.15329_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 11/14/2023] [Indexed: 03/08/2024]
Abstract
ZusammenfassungHintergrund und ZieleLymphogranuloma venereum (LGV) ist eine sexuell übertragene Erkrankung verursacht durch Chlamydia trachomatis (CT), Serovar L1–L3. Eine Zunahme von LGV ist vorwiegend bei Männern, die Sex mit Männern haben (MSM), beobachtet worden. Die Unterscheidung zwischen LGV und Nicht‐LGV‐Serovaren hat therapeutische Konsequenzen, daher wurden Prävalenz und Charakteristika von LGV innerhalb aller CT‐Infektionen untersucht.Patienten und MethodikAlle CT‐positiven Befunde, erhoben an den vier größten österreichischen HIV‐ und STI‐Kliniken von 04/2014–12/2021, wurden hinsichtlich Charakteristika der Erkrankung und Demographie der Patienten ausgewertet.ErgebnisseInsgesamt wurden n = 2083 CT‐Infektionen bei n = 1479 Personen dokumentiert. Das mediane Alter betrug 31,4 Jahre, 81% waren männlich, 59% MSM, 44% HIV‐positiv, 13% nutzten HIV‐Prä‐Expositionsprophylaxe. Serovaranalysen waren bei 61% (1258/2083) verfügbar, wobei L1–L3 in 15% (192/1258) aller Fälle nachgewiesen wurde. Bei MSM mit rektaler CT‐Infektion waren 23% (101/439) LGV. LGV‐Fälle verglichen mit CT‐Infektionen traten vermehrt bei MSM (92% [177/192] vs. 62% [1179/1891], p < 0,001), HIV‐Positivität (64% [116/180] vs. 46% [631/1376]; p < 0,001) und konkomitanter Syphilisinfektion (18% [32/180] vs. 7% [52/749]; p < 0,001) auf. LGV‐Infektionen verliefen zumeist asymptomatisch (45% [87/192]), gefolgt von Proktitis (38% [72/192]).SchlussfolgerungenLymphogranuloma venereum machte 23% der rektalen CT‐Infektionen bei MSM aus und 45% aller LGV‐Fälle waren asymptomatisch. Bei fehlender CT‐Serovar‐Analyse sollte in Risikopopulationen eine erhöhte LGV‐Prävalenz in Betracht gezogen und bei der empirischen Therapiedauer berücksichtigt werden.
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Affiliation(s)
- David Chromy
- Universitätsklinik für Dermatologie, Medizinische Universität Wien, Wien, Österreich
| | - Birgit Sadoghi
- Universitätsklinik für Dermatologie, Venerologie, Medizinische Universität Graz, Graz, Österreich
| | - Irina Gasslitter
- Universitätsklinik für Dermatologie, Venerologie und Allergologie, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - Mattias Skocic
- Universitätsklinik für Dermatologie und Venerologie, Kepler Universitätsklinikum, Linz, Österreich
| | - Anthony Okoro
- Universitätsklinik für Dermatologie, Medizinische Universität Wien, Wien, Österreich
| | | | - Birgit Willinger
- Abteilung für Klinische Mikrobiologie, Klinisches Institut für Labormedizin, Medizinische Universität Wien, Wien, Österreich
| | - Wolfgang Weninger
- Universitätsklinik für Dermatologie, Medizinische Universität Wien, Wien, Österreich
| | - Angela Öllinger
- Universitätsklinik für Dermatologie und Venerologie, Kepler Universitätsklinikum, Linz, Österreich
| | - Mario Sarcletti
- Universitätsklinik für Dermatologie, Venerologie und Allergologie, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - Georg Stary
- Universitätsklinik für Dermatologie, Medizinische Universität Wien, Wien, Österreich
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Campos M, Galán JC, Rodríguez-Domínguez M, Sempere JM, Llorens C, Baquero F. Membrane computing simulation of sexually transmitted bacterial infections in hotspots of individuals with various risk behaviors. Microbiol Spectr 2024; 12:e0272823. [PMID: 38197662 PMCID: PMC10845966 DOI: 10.1128/spectrum.02728-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 12/07/2023] [Indexed: 01/11/2024] Open
Abstract
The epidemiology of sexually transmitted infections (STIs) is complex due to the coexistence of various pathogens, the variety of transmission modes derived from sexual orientations and behaviors at different ages and genders, and sexual contact hotspots resulting in network transmission. There is also a growing proportion of recreational drug users engaged in high-risk sexual activities, as well as pharmacological self-protection routines fostering non-condom practices. The frequency of asymptomatic patients makes it difficult to develop a comprehensive approach to STI epidemiology. Modeling approaches are required to deal with such complexity. Membrane computing is a natural computing methodology for the virtual reproduction of epidemics under the influence of deterministic and stochastic events with an unprecedented level of granularity. The application of the LOIMOS program to STI epidemiology illustrates the possibility of using it to shape appropriate interventions. Under the conditions of our basic landscape, including sexual hotspots of individuals with various risk behaviors, an increase in condom use reduces STIs in a larger proportion of heterosexuals than in same-gender sexual contacts and is much more efficient for reducing Neisseria gonorrhoeae than Chlamydia and lymphogranuloma venereum infections. Amelioration from diagnostic STI screening could be instrumental in reducing N. gonorrhoeae infections, particularly in men having sex with men (MSM), and Chlamydia trachomatis infections in the heterosexual population; however, screening was less effective in decreasing lymphogranuloma venereum infections in MSM. The influence of STI epidemiology of sexual contacts between different age groups (<35 and ≥35 years) and in bisexual populations was also submitted for simulation.IMPORTANCEThe epidemiology of sexually transmitted infections (STIs) is complex and significantly influences sexual and reproductive health worldwide. Gender, age, sexual orientation, sexual behavior (including recreational drug use and physical and pharmacological protection practices), the structure of sexual contact networks, and the limited application or efficiency of diagnostic screening procedures create variable landscapes in different countries. Modeling techniques are required to deal with such complexity. We propose the use of a simulation technology based on membrane computing, mimicking in silico STI epidemics under various local conditions with an unprecedented level of detail. This approach allows us to evaluate the relative weight of the various epidemic drivers in various populations at risk and the possible outcomes of interventions in particular epidemiological landscapes.
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Affiliation(s)
- Marcelino Campos
- Department of Microbiology, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
- Valencian Research Institute for Artificial Intelligence (VRAIN), Polytechnic University of Valencia, Valencia, Spain
| | - Juan Carlos Galán
- Department of Microbiology, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
- Center for Biomedical Research in Epidemiology and Public Health Network (CIBERESP) Madrid, Madrid, Spain
| | - Mario Rodríguez-Domínguez
- Department of Microbiology, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
- Center for Biomedical Research in Epidemiology and Public Health Network (CIBERESP) Madrid, Madrid, Spain
| | - José M. Sempere
- Valencian Research Institute for Artificial Intelligence (VRAIN), Polytechnic University of Valencia, Valencia, Spain
| | - Carlos Llorens
- Biotechvana, Valencia, Scientific Park University of Valencia, Paterna, Spain
| | - Fernando Baquero
- Department of Microbiology, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
- Center for Biomedical Research in Epidemiology and Public Health Network (CIBERESP) Madrid, Madrid, Spain
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Jacques-Aviñó C, Alarcón Guitiérrez M, Barbera MJ, Fuertes I, Martin-Ezquerra G, Lopez-Contreras J, Vives Á, Rodriguez R, Ros M, Rius C, de Olalla PG. Epidemiological Characteristics and Factors Associated with Repeat Sexually Transmitted Infections in Barcelona, Spain Over a Decade. Arch Sex Behav 2024; 53:735-744. [PMID: 37875628 PMCID: PMC10844332 DOI: 10.1007/s10508-023-02711-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 09/12/2023] [Accepted: 09/15/2023] [Indexed: 10/26/2023]
Abstract
In the last few years, the frequency of sexually transmitted infections (STI) has increased, as has the number of people with multiple infections. The aim of our study was to describe the epidemiological characteristics of persons with repeated bacterial STI and to determine the risk factors for these episodes in persons living in Barcelona during the period 2007-2018. We studied all cases of bacterial STI included in the STI registry of Barcelona. Repeated STI were defined as a diagnosis of gonorrhea, syphilis, or lymphogranuloma venereum (LGV) after a first episode of one of these infections. Analysis was stratified by sex and place of birth. The factors associated with time to reinfection were determined by Kaplan-Meier estimates, while the factors associated with risk of infection were determined by a Cox proportional hazards model. Of 9927 persons with a diagnosis of bacterial STI, 1690 (17.0%) had at least two episodes of STI during the study period. On multivariate analysis, repeat STI were independently associated with male sex assigned at birth (HR: 3.45; 95%CI 2.22-5.36), age less than 34 years (HR: 1.22; 95%CI 1.10-1.35); gay, bisexual, and other men who have sex with men, and transgender o transsexual woman (GBSMS/Trans) (HR: 4.03; 95%CI 3.24-5.03), having gonorrhea as first diagnosis (HR:1.49, 95%CI 1.34-1.66) or LGV (HR:1.75; 95%CI 1.47-2.08) and coinfection with HIV (HR:1.98; 95%CI 1.78-2.21). Sexual health programs should be strengthened to prevent STI and reinfection in key populations.
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Affiliation(s)
- Constanza Jacques-Aviñó
- Servei d'Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain.
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Gran Via Corts Catalanes, 587, àtic, 08007, Barcelona, Spain.
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès (Barcelona), Bellaterra, Spain.
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain.
| | - Miguel Alarcón Guitiérrez
- Servei d'Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès (Barcelona), Bellaterra, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
| | - María Jesús Barbera
- Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Irene Fuertes
- Dermatology Department, Hospital Clinic, Barcelona, Spain
| | - Gemma Martin-Ezquerra
- Dermatology Department, Institut Hospital del Mar d'Investigacions Mèdiques, Hospital del Mar, Barcelona, Spain
| | - Joaquín Lopez-Contreras
- Infectious Diseases Unit-Internal Medicine Department, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
| | | | - Raquel Rodriguez
- Servei d'Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Miriam Ros
- Servei d'Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Cristina Rius
- Servei d'Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Patricia Garcia de Olalla
- Servei d'Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
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Haitsma Mulier JLG, van Beurden YH, van Eijck BC, van der Reijden WA, van Lelyveld SFL. [Rectal lesions and liver lesions caused by syphilis]. Ned Tijdschr Geneeskd 2021; 165:D5669. [PMID: 34854615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Syphilis is a sexually transmitted disease, caused by the spirochete Treponema Pallidum. Many different manifestations exist, which can complicate diagnosis. CASE A 36-year-old man with a known HIV infection, presented himself with rectal blood loss and abdominal pain. Abdominal ultrasound and abdominal CT were suspicious for malign liver metastases. During subsequent colonoscopy, benign looking rectal lesions were found, possibly caused by either lymphogranuloma venereum or syphilis. Additional diagnostics confirmed an active syphilis infection. After treatment with benzylpenicillin, patient's complaints resolved, as well as the lesions in rectum and liver. CONCLUSION We describe a rare case of a patient with secondary syphilis, presenting with rectal lesions and liver lesions suspicious for malign metastases.
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Neri B, Stingone C, Romeo S, Sena G, Gesuale C, Compagno M, De Cristofaro E, Baciorri F, Del Vecchio Blanco G, Palmieri G, Sarmati L, Biancone L. Inflammatory bowel disease versus Chlamydia trachomatis infection: a case report and revision of the literature. Eur J Gastroenterol Hepatol 2020; 32:454-457. [PMID: 31851086 DOI: 10.1097/meg.0000000000001605] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Infectious proctitis may mimic inflammatory bowel disease, particularly when limited to the rectum. The present case report includes findings from a 50-year-old man, soldier, referring to our Inflammatory Bowel Disease Unit with a diagnosis of rectal Crohn's disease, refractory to conventional treatments. Mild anemia, hypergammaglobulinemia and HIV-antibodies seronegativity were detected. Entero-MRI and stool examinations were negative. Ileocolonoscopy detected few rectal ulcers with irregular edges. Endosonography showed marked thickening of the rectal wall and enlarged perirectal lymphnodes. Nodal and rectal fine needle aspirate did not show atypia (PAN CK-). Rectal biopsies showed flogistic granular tissue (PAN CK-): Warthin-Starry stain was negative. Previous Treponema pallidum infection was detected. Clinical history revealed habits at risk for sexually transmitted infection. Rectal swabs for RT-PCR for Chlamydia trachomatis, Neisseria gonorrhoeae, and Herpes Simplex Virus 1-2 lead to a diagnosis of lymphogranuloma venereum. Doxycycline 100 mg and Azitromicyn 500 mg t.i.d. were given for 21 days, followed by negativity for RT-PCR for Chlamydia trachomatis at rectal swabs. Complete disappearance of symptoms and mucosal healing occurred. Due to the increased frequency of infectious diseases, sexually transmitted infection (including lymphogranuloma venereum) should be considered as possible differential diagnosis when assessing patients with inflammatory bowel disease limited to the rectum.
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Affiliation(s)
- Benedetto Neri
- Department of Systems Medicine, Unit of Gastroenterology, University 'Tor Vergata' of Rome
| | - Christof Stingone
- Department of Systems Medicine, Unit of Infectious Diseases, University 'Tor Vergata' of Rome, Rome
| | - Samanta Romeo
- Department of Systems Medicine, Unit of Gastroenterology, University 'Tor Vergata' of Rome
- AAST Ospedale Maggiore di Crema, Scienze mediche, Unità di Gastroenterologia ed Endoscopia Digestiva, Crema
| | - Giorgia Sena
- Department of Systems Medicine, Unit of Gastroenterology, University 'Tor Vergata' of Rome
| | - Cristina Gesuale
- Department of Systems Medicine, Unit of Gastroenterology, University 'Tor Vergata' of Rome
| | - Mirko Compagno
- Department of Systems Medicine, Unit of Infectious Diseases, University 'Tor Vergata' of Rome, Rome
| | - Elena De Cristofaro
- Department of Systems Medicine, Unit of Gastroenterology, University 'Tor Vergata' of Rome
| | | | | | | | - Loredana Sarmati
- Department of Systems Medicine, Unit of Infectious Diseases, University 'Tor Vergata' of Rome, Rome
| | - Livia Biancone
- Department of Systems Medicine, Unit of Gastroenterology, University 'Tor Vergata' of Rome
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SAINT JOHN E, GORDON FB. Studies on the immunological relationships of the psittacosis- lymphogranuloma venereum group of viruses. J Infect Dis 2010; 80:297-306. [PMID: 20247935 DOI: 10.1093/infdis/80.3.297] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kucinskiene V, Sutaite I, Valiukeviciene S, Milasauskiene Z, Domeika M. Prevalence and risk factors of genital Chlamydia trachomatis infection. Medicina (Kaunas) 2006; 42:885-94. [PMID: 17172789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The aim of the study was to provide a survey and generalization of literature data on the epidemiological situation of Chlamydia trachomatis infection in various countries, preventive screenings and risk factors of the infection. We performed a survey of articles published during 1998-2005 and selected from bibliographical medical search databases presenting data on the prevalence of Chlamydia trachomatis and the main risk factors for this sexually transmitted infection. Chlamydial infection is the most common among sexually transmitted genital infections worldwide. It has been found that the main risk factors for Chlamydia trachomatis infection are age, irregular and/or accidental sexual relationships and change of sexual partners, failure to use or erratic use of barrier contraception during intercourse, and insufficient knowledge about sexual life and care for one's sexual health. Most countries do not have national preventive screening programs or exhaustive information about the prevalence of Chlamydia trachomatis infection. The comparison of the prevalence and incidence of Chlamydia trachomatis infection among different countries is complicated due to the different diagnostic methods and sample selection techniques applied; however, in order to decrease the prevalence of chlamydial infection and its impact on the reproductive health of the society, significant attention should be paid to sexual education, preventive screening of people in high-risk groups, as well as to early diagnostics and timely treatment.
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Affiliation(s)
- Vesta Kucinskiene
- Clinic of Dermatological and Venereal Diseases, Kaunas University of Medicine, Eiveniu 2, 50009 Kaunas, Lithuania.
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MANIRE GP, MEYER KF. The toxins of the psittacosis-lymphogranuloma group of agents; the toxicity of various members of the psittacosis- lymphogranuloma venereum group. J Infect Dis 2004; 86:226-32. [PMID: 15415625 DOI: 10.1093/infdis/86.3.226] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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WOMMOCK VS, GREENBLATT RB, DIENST RB, CHEN C, WEST RM. Aureomycin in the treatment of granuloma inguinale and lymphogranuloma venereum. J Invest Dermatol 2004; 14:427-34. [PMID: 15428705 DOI: 10.1038/jid.1950.54] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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HURST EW, PETERS JM, MELVIN P. The therapy of experimental psittacosis and lymphogranuloma venereum (inguinale). I. The comparative efficacy of penicillin, chloramphenicol, aureomycin, and terramycin. Br J Pharmacol Chemother 2004; 5:611-24. [PMID: 14801466 PMCID: PMC1509986 DOI: 10.1111/j.1476-5381.1950.tb00611.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ishihara S, Kawada Y. [Lymphogranuloma inguinale]. Ryoikibetsu Shokogun Shirizu 1999:36-7. [PMID: 10337733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Affiliation(s)
- S Ishihara
- Department of Urology, Gifu University School of Medicine
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WOOLRIDGE RL, JACKSON EB, GRAYSTON JT. Serological relationship of trachoma, psittacosis and lymphogranuloma venereum viruses. Exp Biol Med (Maywood) 1998; 104:298-301. [PMID: 13845952 DOI: 10.3181/00379727-104-25815] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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MOULDER JW. Some basic properties of the psittacosis- lymphogranuloma venereum group of agents. Structure and chemical composition of isolated particles. Ann N Y Acad Sci 1998; 98:92-9. [PMID: 14476628 DOI: 10.1111/j.1749-6632.1962.tb30535.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Morise K, Yamamoto H, Kusugami K. [Chlamydia trachomatis proctitis]. Ryoikibetsu Shokogun Shirizu 1994:167-169. [PMID: 7736009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Affiliation(s)
- K Morise
- First Department of Internal Medicine, Nagoya University School of Medicine
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Abstract
All physicians share a responsibility for educating the public in the expanding risks of sexually transmitted diseases, and in the vital importance of safe sexual practices. Both the public health implications of undiagnosed STDs and the adverse social consequences of an incorrect diagnosis emphasize the need to comprehensively and precisely diagnose these diseases, despite the problems encountered in obtaining material for culture. Current interest in AIDS should not obscure the facts that genital herpes continues to increase in prevalence, and that syphilis no longer is declining. The many extragenital syndromes associated with STDs, such as perihepatitis, polyarthritis, and acute septic states make it necessary to evaluate all sexual contacts.
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Dunlop EM. Chlamydial genital infection and its complications. Br J Hosp Med (Lond) 1983; 29:6-11. [PMID: 6824804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Henry-Suchet J, Catalan F, Loffredo V, Serfaty D, Siboulet A, Perol Y, Sanson MJ, Debache C, Pigeau F, Coppin R, de Brux J, Poynard T. Microbiology of specimens obtained by laparoscopy from controls and from patients with pelvic inflammatory disease or infertility with tubal obstruction: Chlamydia trachomatis and Ureaplasma urealyticum. Am J Obstet Gynecol 1980; 138:1022-5. [PMID: 6451177 DOI: 10.1016/0002-9378(80)91100-x] [Citation(s) in RCA: 84] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
We cultured for Chlamydia trachomatis, Ureaplasma urealyticum, and Mycoplasma hominis and performed chlamydial serologic studies in 99 women undergoing laparoscopy. These women included patients with acute salpingitis, infertile women with and without mild pelvic inflammatory disease, and controls. C. trachomatis infection was significantly more common in patients than in controls. We also identified low-grade "silent" PID among women with infertility resulting from tubal obstruction and suggest this may be caused by chlamydiae.
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Svensson L, Weström L, Ripa KT, Mårdh PA. Differences in some clinical and laboratory parameters in acute salpingitis related to culture and serologic findings. Am J Obstet Gynecol 1980; 138:1017-21. [PMID: 6451176 DOI: 10.1016/0002-9378(80)91099-6] [Citation(s) in RCA: 114] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Women with laparoscopically verified acute salpingitis (AS) were studied, and 151 were classified as having: chlamydia-associated AS (C-AS), gonococcal-associated AS (G-AS), and nonchlamydial, nongonococcal-associated AS (NCNG-AS). Patients with G-AS were more often febrile (rectal temperature greater than 38 degrees C) and more often had a moderately elevated erythrocyte sedimentation rate (ESR) (16 to 30 mm/hr) compared to other patients. Women with NCNG-AS were more likely to have a normal ESR and a mild inflammatory reaction laparoscopically. C-AS women were more likely to have had pelvic pain for more than 3 days before seeking treatment and to have an ESR of greater than 30 mm/hr on admission. Predisposing factors to AS, such as insertion of intrauterine device, hysterosalpingography, and curettage within 4 weeks of admission, were more common in the C-AS group. The tubal inflammatory changes in the C-AS group were generally more severe than expected from the relatively benign clinical course.
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Møller BR, Freundt EA, Märdh PA. Experimental pelvic inflammatory disease provoked by Chlamydia trachomatis and Mycoplasma hominis in grivet monkeys. Am J Obstet Gynecol 1980; 138:990-5. [PMID: 7468686 DOI: 10.1016/0002-9378(80)91094-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Pelvic inflammatory disease was produced by inoculation with Mycoplasma hominis and Chlamydia trachomatis directly into the fallopian tubes of grivet monkeys. The effects of various routes of infection were examined. The method of inoculation with the infecting agent influenced the resulting clinical spectrum. In these monkeys significant changes in humoral antibodies occurred with inflammation caused by both M. hominis and C. trachomatis. Development of cellular antibodies against M. hominis could be demonstrated in all experimentally infected monkeys, whereas no such antibodies could be detected in monkeys with chlamydia salpingitis. M. hominis in female grivet monkeys may spread from the cervix or the uterine cavity, probably via blood vessels and lymphatics, producing parametritis and "exosalpingitis." C. trachomatis may spread from the cervix via the uterine mucosa, producing endosalpingitis with destruction of the epithelium. The infection caused by M. hominis in the genital tract of female grivet monkeys resembles "nongonococcal" salpingitis while C. trachomatis produces infection resembling "gonococcal" salpingitis.
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Sweet RL, Draper DL, Schachter J, James J, Hadley WK, Brooks GF. Microbiology and pathogenesis of acute salpingitis as determined by laparoscopy: what is the appropriate site to sample? Am J Obstet Gynecol 1980; 138:985-9. [PMID: 6451179 DOI: 10.1016/0002-9378(80)91093-5] [Citation(s) in RCA: 100] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Acute salpingitis is a polymicrobial disease. Neisseria gonorrhoeae and anaerobic gram-positive cocci were the predominant microorganisms isolated from the fallopian tubes of salpingitis patients. Gonococci were isolated from the fallopian tubes in eight of 35 (23%) patients; anaerobic bacteria were recovered from 10 of 35 (28.5%). Although Chlamydia trachomatis was not recovered from the fallopian tube exudate, there was abundant serologic evidence of chlamydial infection in the salpingitis patients. Twenty-three percent of patients with paired sera had a fourfold rise in IgM and IgG titer, which was consistent with systemic chlamydial infection. Comparison of cultures obtained via laparoscopy and culdocentesis suggested that culdocentesis is not an accurate reflection of the microbial milieu in the fallopian tube.
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Abstract
The treatment of pelvic inflammatory disease depends upon the etiology of the condition. Pelvic infection (PI) after parturition and abortion, gynecologic surgery, and a variety of invasive procedures is commonly associated with the isolation of anaerobic and aerobic flora of the vagina. The factors which influence the choice of antimicrobial treatment and the role of Bacteroides fragilis and Escherichia coli are discussed. Sexually transmissible agents of importance are Neisseria gonorrhoeae and Chlamydia trachomatis. Pelvic infections associated with these pathogens require antibiotics which exert an optimum effect against them. Examination and treatment of the sexual partner(s) are important. The possible role of the anaerobic and aerobic vaginal flora as opportunistic secondary pathogens is discussed. Developments in the surgical treatment of the sequelae of PID are reviewed. The results of treatment of uncomplicated gonorrhea in 262 women are reported. C. trachomatis was isolated from 53% of women before treatment. After treatment, PI developed in 11 women who had been given penicillin and in one woman who had been given tetracycline (P = 0.0071). It is suggested that recognition and treatment of postgonococcal cervicitis in women treated for uncomplicated gonorrhea with penicillin might provide one form of preventive treatment for nongonococcal PI.
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Abstract
We studied 23 patients with pelvic inflammatory disease associated with symptoms of pleuritic up'per abdominal pain, characteristic of Fitz-Hugh-Curtis syndrome (FHC). A fourfold or greater change in antibody titer to Chlamydia trachomatis was demonstrated by microimmunofluorescence in 14; an IgG antibody titer greater than or equal to 1:1,024 was seen in 13; and IgM antibody was demonstrated in 11. Twenty (87%) of the 23 FHC patients, including all of the 12 with paired sera obtained at least 6 weeks apart, had serologic evidence of acute C. trachomatis infection. Neisseria gonorrhoeae was isolated from seven (30%) of the 23 FHC cases, and C. trachomatis was isolated from three of 10. Two groups of matched controls were studied; one group with PID but without FHC, and the other without PID. A larger proportion of patients with FHC had serologic evidence of acute C. trachomatis infection than either of the two control groups (p less than 0.05 for each comparison). Among those with antibody to C. trachomatis, the geometric mean antibody titer for the FHC group (1:724) was significantly higher than that for the PID group (1:138) or for the non-PID group (1:103). Thus, FHC is not solely attributable to infection with N. gonorrhoeae; most cases are associated with acute C. trachomatis infection.
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Wager GP, Martin DH, Koutsky L, Eschenbach DA, Daling JR, Chiang WT, Alexander ER, Holmes KK. Puerperal infectious morbidity: relationship to route of delivery and to antepartum Chlamydia trachomatis infection. Am J Obstet Gynecol 1980; 138:1028-33. [PMID: 7468665 DOI: 10.1016/0002-9378(80)91102-3] [Citation(s) in RCA: 113] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
We investigated the relationship of route of delivery and of antepartum Chlamydia trachomatis cervical infection to selected forms of puerperal infectious morbidity, including intrapartum fever, or early (less than 48 hours) postpartum fever not attributable to infections of sites outside the uterus and late (48 hours to 6 weeks) postpartum endometritis. Infectious morbidity occurred in 27 (44%) of 62 women who underwent cesarean section and in 33 (10%) of 329 who underwent vaginal delivery (p less than 0.001). Postsection infectious morbidity was not correlated with C. trachomatis infection and was largely limited to early postpartum fever. Among women who underwent vaginal delivery, infectious morbidity occurred in 10 (34%) of 29 women with and in 23 (8%) of 300 without C. trachomatis infection (p less than 0.001), and chlamydial infection was associated only with intrapartum fever and late postpartum endometritis. Separate matched case-control analyses confirmed that cesarean section was associated with an increased risk of early postpartum fever (p = 4 x 10(-8)); whereas among women who underwent vaginal delivery, antepartum C trachomatis infection was associated with an increased risk of development of intrapartum fever or late postpartum endometritis (p = 0.002).
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Clavé M. [Sexually transmissible diseases]. Rev Infirm 1978; 28:367-73. [PMID: 247565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Schachter J, Causse G, Tarizzo ML. Chlamydiae as agents of sexually transmitted diseases. Bull World Health Organ 1976; 54:245-54. [PMID: 1088107 PMCID: PMC2366565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Chlamydiae are being increasingly recognized as an important cause of human disease. The known geographical distribution of lymphogranuloma venereum and the role of chlamydiae as agents of sexually transmitted diseases are reviewed. The presence of chlamydiae in the urethra and the cervix, and their etiological relationship to genital infections, first recognized in connexion with ocular infections, have been proved in a number of studies in selected populations in a few countries. Chlamydiae appear to be the most important agent of nongonococcal urethritis, which in some cases appears now to be more frequent than gonococcal urethritis. In addition to their association with cervicitis, chlamydiae appear also to be fairly frequent in the cervix of apparently normal, asymptomatic, and sexually active women. The role of chlamydiae as agents of other human diseases still requires to be clarified. The organisms have been found in association with pelvic inflammatory disease, neonatal pneumonia, pharyngitis, and otitis. There is need for additional studies in view of the fact that effective chemotherapy is available. An outline is given of laboratory methods that may be useful for the diagnosis of chlamydial infections.
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Fan VS, Jenkin HM. Biosynthesis of Phospholipids and neutral lipids of monkey kidney cells (LLC-MK-2) infected with Chlamydia trachomatic strain lymphogranuloma venereum (38538). Proc Soc Exp Biol Med 1975; 148:351-7. [PMID: 804699 DOI: 10.3181/00379727-148-38538] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The biosynthesis of phospho-lipids and neutral lipids in normal and monkey kidney cells infected with lymphogranuloma venereum were compared using 14C-acetate and 14-C-serine in pulse-chase experiments. Synthesis of phospholipids and nutral glycerolipids were inhibited in infected cells. Phosphatidyl ethanolamine (PE) synthesis increased while phosphatidyl choline, phosphatidyl serine and cardiolipin synthesis decreased in infected cells within 36 hr after infection. Sphingomyelin syntheisis decreased after 48 hr of infection. The synthesis of PE in the infected cell followed a similar pathway found in bacteria and could be distinguished from the normal host cell. An explanation of the parsitic requirement for lipid precursors has been proposed.
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Soullard J. [Anal venereology]. Rev Prat 1972; 22:1817-25. [PMID: 4678708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Anderson JR. Case report of student aviator with unusual psychosomatic symptoms. Aerosp Med 1971; 42:1217-8. [PMID: 5119693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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44
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Young AW. Cutaneous inflammations of the male genitalia. Mod Treat 1970; 7:973-98. [PMID: 4327026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Schmidt W. [Venereal diseases]. Agnes Karll Schwest Krankenpfleger 1969; 23:424-7. [PMID: 5194907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Oates JK. The sexually transmitted diseases. 4. Minor infections. Nurs Mirror Midwives J 1969; 128:38-9. [PMID: 5191014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Stewart DB. Tropical gynaecology. Ulcerative and hypertrophic lesions of the vulva. Proc R Soc Med 1968; 61:363-5. [PMID: 5653997 PMCID: PMC1902346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Willcox RR. Perspectives in venereology--1966. Bull Hyg (Lond) 1967; 42:1169-200. [PMID: 4867717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Parturier-Albot M, Miansarow H. [Benign tumors, pseudo-tumors and hamartomas of the rectum]. Actual Hepatogastroenterol (Paris) 1967; 3:361-91. [PMID: 4863314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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