scholarly journals Challenges in Treating Secondary Syphilis Osteitis in an Immunocompromised Patient with a Penicillin Allergy: Case Report and Review of the Literature

2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Robert Ali ◽  
Julio Perez-Downes ◽  
Firas Baidoun ◽  
Bashar Al Turk ◽  
Carmen Isache ◽  
...  
Keyword(s):  
Immunocompromised Patient ◽  
Alternative Therapy ◽  
Skin Lesions ◽  
Secondary Syphilis ◽  
Penicillin Allergy ◽  
Dramatic Improvement ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Immunodeficiency Virus

Syphilis is a sexually transmitted infection that remains fairly commonplace. The introduction of penicillin aided in curbing the incidence of disease; however, with the advent of the human immunodeficiency virus (HIV), syphilis is now on a resurgence with sometimes curious presentations. We present a case of a 36-year-old Caucasian gentleman with untreated HIV who complained of a skin eruption and joint pains for 6 weeks, prompting the diagnosis of secondary syphilis osteitis. Skin lesions were reminiscent of “malignant” syphilis. CD4 count was 57 cells/μL. RPR was elevated with 1 : 64 titer and positive confirmatory TP-PA. Radiography of the limbs revealed polyostotic cortical irregularities corroborated on bone scintigraphy. The patient had an unknown penicillin allergy and was unwilling to conduct a trial of penicillin-based therapy. He was subsequently treated with doxycycline 100 mg twice daily for 6 weeks and commenced antiretroviral therapy, noting dramatic improvement in both the skin lesions and joint pains. Unfortunately, he defaulted on follow-up, precluding serial RPR and bone imaging. Penicillin allergies have proven to be quite a conundrum in such patients, without much recourse for alternative therapy. Doxycycline with/without azithromycin is other options worth considering.

scholarly journals Eosinophil rich infiltrate in secondary syphilis a rare histopathological variant

2021 ◽  
Vol 7 (4) ◽  
pp. 605
Author(s):  
Vidya D. Kharkar ◽  
Harish B. Rajendran
Keyword(s):  
Plasma Cells ◽  
Wide Spectrum ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Secondary Syphilis ◽  
Transmitted Infection ◽  
Moderate Amount ◽  
Sexually Transmitted ◽  
Inflammatory Dermatoses ◽  
Perivascular Infiltrate

<p class="abstract">Secondary syphilis is a sexually transmitted infection, which is referred to as “the great imitator” and has a wide spectrum of clinical manifestations. Syphilis is classically associated with plasma cells and the presence of eosinophils usually argues against a diagnosis of syphilis. The differential diagnosis for eosinophil-rich skin lesions often includes a drug reaction, arthropod-bite reaction, allergic contact dermatitis, and a response to a helminth infestation. However, many unrelated entities, such as infections, neoplasms, and inflammatory dermatoses can have prominent eosinophilic infiltrate. We report a case of secondary syphilis which on histopathology showing psoriasiform hyperplasia with superficial perivascular infiltrate and on higher magnification these infiltrate were predominantly lymphohistiocytic along with the moderate amount of eosinophils with a paucity of plasma cells. This case report is presented to highlight the need for including secondary syphilis as one of the differential diagnoses in the presence of eosinophil-rich infiltrate when it is suspected clinically.</p>

scholarly journals Extensive Condylomata Lata as the Only Manifestation of Secondary Syphilis

2021 ◽  
Vol 79 (3) ◽  
pp. 279-281
Author(s):  
Rita Bouceiro-Mendes ◽  
Leandro Silva ◽  
Pablo Espinosa-Lara ◽  
Luís Soares-de-Almeida ◽  
J. Borges-da-Costa
Keyword(s):  
Young Male ◽  
Developed Countries ◽  
Secondary Syphilis ◽  
New Wave ◽  
Syphilis Infection ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Clinical Presentations ◽  
Immunodeficiency Virus ◽  
Sex With Men

Syphilis is a sexually transmitted infection with a multiplicity of clinical presentations that has been known for centuries. Recently, a new wave of syphilis has been reported in developed countries and men who have sex with men, especially those coinfected with human immunodeficiency virus (HIV), have the highest rates of syphilis infection. In these patients, cutaneous manifestation can be even more diverse. We report a case of secondary syphilis in a young male patient coinfected with HIV whose presentation consisted of extensive condylomata lata lesions.

scholarly journals Improved molecular laboratory productivity by consolidation of testing on the new random-access analyzer Alinity m

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Martin Obermeier ◽  
Monia Pacenti ◽  
Robert Ehret ◽  
Francesco Onelia ◽  
Rory Gunson ◽  
...  
Keyword(s):  
Trichomonas Vaginalis ◽  
Random Access ◽  
Mycoplasma Genitalium ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
B Virus ◽  
Immunodeficiency Virus ◽  
International Multicenter Study ◽  
Laboratory Productivity ◽  
Laboratory Workflow

AbstractObjectivesAutomated molecular analyzers have accelerated diagnosis, allowing earlier intervention and better patient follow-up. A recently developed completely automated molecular analyzer, Alinity™ m (Abbott), offers consolidated, continuous, and random-access testing that may improve molecular laboratory workflow.MethodsAn international, multicenter study compared laboratory workflow metrics across various routine analyzers and Alinity m utilizing assays for human immunodeficiency virus type 1 (HIV-1), hepatitis C virus (HCV), hepatitis B virus (HBV), high-risk human papillomavirus (HR HPV), and sexually transmitted infection (STI) (Chlamydia trachomatis [CT]/Neisseria gonorrhoeae [NG]/Trichomonas vaginalis [TV]/Mycoplasma genitalium [MG]). Three turnaround times (TATs) were assessed: total TAT (sample arrival to result), sample onboard TAT (sample loading and test starting to result), and processing TAT (sample aspiration to result).ResultsTotal TAT was reduced from days with routine analyzers to hours with Alinity m, independent of requested assays. Sample onboard TATs for standard workflow using routine analyzers ranged from 7 to 32.5 h compared to 2.75–6 h for Alinity m. The mean sample onboard TAT for STAT samples on Alinity m was 2.36 h (±0.19 h). Processing TATs for Alinity m were independent of the combination of assays, with 100% of results reported within 117 min.ConclusionsThe consolidated, continuous, random-access workflow of Alinity m reduces TATs across various assays and is expected to improve both laboratory operational efficiency and patient care.

2017 European guidelines for the management of genital herpes

2017 ◽  
Vol 28 (14) ◽  
pp. 1366-1379 ◽  
Author(s):  
Rajul Patel ◽  
Oliver J Kennedy ◽  
Emily Clarke ◽  
Anna Geretti ◽  
Arvid Nilsen ◽  
...  
Keyword(s):  
Genital Herpes ◽  
Early Recognition ◽  
Recurrent Genital Herpes ◽  
Sexually Transmitted ◽  
European Guidelines ◽  
Duration Of Illness ◽  
Clinical Scenarios ◽  
Immunodeficiency Virus ◽  
Initiation Of Therapy

Genital herpes is one of the commonest sexually transmitted infections worldwide. Using the best available evidence, this guideline recommends strategies for diagnosis, management, and follow-up of the condition as well as for minimising transmission. Early recognition and initiation of therapy is key and may reduce the duration of illness or avoid hospitalisation with complications, including urinary retention, meningism, or severe systemic illness. The guideline covers a range of common clinical scenarios, such as recurrent genital herpes, infection during pregnancy, and co-infection with human immunodeficiency virus.

scholarly journals Men treated for syphilis in Białystok, Poland, 2014-2018

2019 ◽  
pp. 329-335
Author(s):  
Agnieszka Beata Serwin ◽  
Adriana Grochowska ◽  
Iwona Flisiak
Keyword(s):  
Urban Areas ◽  
Partner Notification ◽  
Secondary Syphilis ◽  
Contact Tracing ◽  
Professional Activity ◽  
Symptomatic Infection ◽  
Sexually Transmitted ◽  
Sexual Contacts ◽  
Sex With Men

INTRODUCTION. Incidence of syphilis is increasing in Europe in recent years, mainly due to high incidence in men, especially men who have sex with men (MSM). AIM. To analyse sociodemographic, epidemiological and clinical characteristics of men treated for syphilis in Bialystok in 2014 – 2018, to compare these of MSM and men who have sex with women (MSW). MATERIAL AND METHODS. Analysis of age, residency, professional activity, type of sexual contacts (steady vs. casual), marital status, stage of syphilis diagnosed, concomitant sexually transmitted infections (STIs), treatment, partner notification and follow-up attendance. RESULTS. Of 49 male patients with syphilis 26 (53.06%) were MSM and 23 (46.94%) – MSW. The average age was 33.67 and 35.87 years in MSM and MSW patients, respectively. Majority of patients in both groups were residents of urban areas. Tradesmen and those unemployed constituted the highest proportion in MSM and MSW group, respectively. MSM were in majority single and had only casual contacts while MSW, mostly married or engaged in steady relationship, had also casual contacts. Secondary syphilis was most frequently diagnosed in MSM and late latent syphilis - in MSW. Eight patients (16.32%) had concomitant HIV infection, in all diagnosed before syphilis. Contact tracing was successful in 26.92% of MSM and 39.13% of MSW. Follow-up was not done or not completed in half of MSM and more than half of MSW. CONCLUSIONS. Results confirm that MSM play a crucial role in the current epidemics of syphilis. They have mainly casual sexual contacts and have symptomatic infection. In both MSM and MSW contact tracing and follow-up attendance is suboptimal.

scholarly journals Immediate PrEP after PEP: Results from an Observational Nurse-Led PEP2PrEP Study

2020 ◽  
Vol 19 ◽  
pp. 232595822093976
Author(s):  
Patrick O’Byrne ◽  
Lauren Orser ◽  
Amanda Vandyk
Keyword(s):  
Seroconversion Rate ◽  
Male Partner ◽  
Post Exposure Prophylaxis ◽  
Hiv Status ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Control And Prevention ◽  
Hiv Acquisition ◽  
Exposure Prophylaxis

Patients who use post-exposure prophylaxis (PEP) are at ongoing risk for HIV acquisition after completing PEP. While the Centers for Disease Control and Prevention recommends pre-exposure prophylaxis (PrEP) use immediately after PEP, some practitioners are hesitant to offer PEP-to-PrEP (PEP2PrEP). We began offering PEP2PrEP in the sexually transmitted infection clinic in Ottawa, Canada on August 5, 2018. During the first 16 months of PEP2PrEP, 61 patients requested PEP and 46 were initiated; 30 of these patients agreed to PEP2PrEP and 26 followed through. None of our PEP patients had confirmed HIV exposures; all fulfilled the initiation criterion of condomless anal sex with a male partner of unknown HIV-status. During the study, the number of PEP requests and initiations was statistical unchanged, yet the seroconversion rate among patients who used PEP decreased from 1.7% pre-PEP2PrEP to 0% post-PEP2PrEP. Regarding follow-up, most discontinuations occurred between the PrEP intake and 1-month follow-up visit.

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