Prevalence and predictors of Lymphogranuloma venereum in a high risk population attending a STD outpatients clinic in Italy

We evaluated LGV prevalence and predictors in a high risk population attending a STI Outpatients Clinic in the North of Italy. METHODS: A total of 108 patients (99 MSM and 9 women), with a history of unsafe anal sexual intercourses, were enrolled. Anorectal swabs and urine samples were tested for Chlamydia trachomatis (CT) DNA detection by Versant CT/GC DNA 1.0 Assay (Siemens Healthcare Diagnostics Terrytown, USA). RFLP analysis was used for CT molecular typing. RESULTS: L2 CT genotype was identified in 13/108 (12%) rectal swabs. All LGV cases were from MSM, declaring high-risk sexual behaviour and complaining anorectal symptoms. Patients first attending the STI Outpatient Clinic received a significant earlier LGV diagnosis than those first seeking care from general practitioners or gastroenterologists (P\u2009=\u20090.0046). LGV prevalence and characteristics found in our population are in agreement with international reports. Statistical analysis showed that LGV positive patients were older (P\u2009=\u20090.0008) and presented more STIs (P\u2009=\u20090.0023) than LGV negative ones, in particular due to syphilis (P\u2009<\u20090.001), HIV (P\u2009<\u20090.001) and HBV (P\u2009=\u20090.001).Multivariate logistic regression analysis revealed that HIV and syphilis infections are strong risk factors for LGV presence (respectively, P\u2009=\u20090.001 and P\u2009=\u20090.010). CONCLUSIONS: Even if our results do not provide sufficient evidence to recommend routine screening of anorectal swabs in high-risk population, they strongly suggest to perform CT NAAT tests and genotyping on rectal specimens in presence of ulcerative proctitis in HIV and/or syphilis-positive MSM. In this context, CT DNA detection by Versant CT/GC DNA 1.0 Assay, followed by RFLP analysis for molecular typing demonstrated to be an excellent diagnostic algorithm for LGV identification

Lymphogranuloma venereum proctitis mimicking inflammatory bowel diseases in 11 patients: a 4-year single-center experience

ABSTRACT Lymphogranuloma venereum (LGV) is a sexually transmitted disease caused by Chlamydia trachomatis (CT) serovars L1–L3. Our study wants to underline the similarities between rectal LGV and idiopathic inflammatory bowel diseases (IBD), which can share clinical, endoscopic and histopathological findings

Human T-lymphotropic virus type 1 (HTLV-1) prevalence and quantitative detection of DNA proviral load in individuals with indeterminate/positive serological results

BACKGROUND: HTLV-1 infection is currently restricted to endemic areas. To define the prevalence of HTLV-1 infection in patients living in Italy, we first carried out a retrospective serological analysis in a group of people originating from African countries referred to our hospital from January 2003 to February 2005. We subsequently applied a real time PCR on peripheral blood mononuclear cells from subjects with positive or indeterminate serological results. METHODS: All the sera were first analysed by serological methods (ELISA and/or Western Blotting) and then the peripheral blood mononuclear cells from subjects with positive or inconclusive serological results were analyzed for the presence of proviral DNA by a sensitive SYBR Green real time PCR. In addition, twenty HTLV-I ELISA negative samples were assayed by real time PCR approach as negative controls. RESULTS: Serological results disclosed serum reactivity by ELISA (absorbance values equal or greater than the cut-off value) in 9 out of 3408 individuals attending the Sexually Transmitted Diseases Clinic and/or Oncology Department, and 2 out 534 blood donors enrolled as a control population. Irrespective of positive or inconclusive serological results, all these subjects were analyzed for the presence of proviral DNA in peripheral blood mononuclear cells by SYBR real time PCR. A clear-cut positive result for the presence of HTLV-1 DNA was obtained in two subjects from endemic areas. CONCLUSION: SYBR real time PCR cut short inconclusive serological results. This rapid and inexpensive assay showed an excellent linear dynamic range, specificity and reproducibility readily revealing and quantifying the presence of virus in PBMCs. Our results highlight the need to monitor the presence of HTLV-1 in countries which have seen a large influx of immigrants in recent years. Epidemiological surveillance and correct diagnosis are recommended to verify the prevalence and incidence of a new undesirable phenomenon

Papillomatous Erythematous Plaques of the Scrotum

We describe an uncommon case of papillomatous erythematous plaques of the scrotum

Valutazione del sistema BD ProbeTec CT/GC Qx DNA Amplified assay su piattaforma BD Viper LT per la diagnosi molecolare di infezioni da Chlamydia trachomatis e Neisseria gonorrhoeae

INTRODUZIONE: Chlamydia trachomatis e Neisseria gonorroheae sono i principali patogeni ad eziologia batterica coinvolti nelle infezioni sessualmente trasmesse. Sebbene siano microorganismi dalle caratteristiche molto diverse, portano a manifestazioni cliniche simili e spesso confondenti. Negli ultimi anni, per la diagnosi di laboratorio di tali batteri, si \ue8 ampiamente diffuso l\u2019uso di metodiche di amplificazione degli acidi nucleici, caratterizzate da sensibilit\ue0 e specificit\ue0 maggiori rispetto alle metodiche tradizionali di coltura e/o identificazione di antigeni. In particolare, si \ue8 affermato l\u2019uso di test multiplex, che permettono di determinare parallelamente pi\uf9 patogeni a partire dallo stesso campione biologico. Lo scopo di questo studio \ue8 stato quello di valutare le performance del BD ProbeTec CT/GC Qx DNA Amplified assay su piattaforma BD Viper LT per la diagnosi delle infezioni da clamidia e gonococco, in comparazione ai dati ottenuti con il test VERSANT CT/GC 1.0 (Real-time PCR) (Siemens). METODI: Sono stati analizzati, in maniera retrospettiva, 352 campioni progressivi pervenuti al laboratorio di Microbiologia del Policlinico Sant\u2019Orsola-Malpighi di Bologna per la ricerca di acidi nucleici di C. trachomatis e N. gonorrhoeae. In totale, 232 campioni erano stati raccolti da soggetti recatisi in poliambulatori presenti sul territorio comunale e provinciale di Bologna (26 tamponi e 141 urine), mentre 120 urine e 65 tamponi provenivano da pazienti dell\u2019ambulatorio di Malattie a Trasmissione Sessuale (MTS) del Policlinico. I campioni sono stati testati con il kit VERSANT CT/GC 1.0, attualmente utilizzato nella routine diagnostica e successivamente con il BD ProbeTec CT/GC Qx DNA Amplified assay su piattaforma BD Viper LT. Le due metodiche si avvalgono di sistemi altamente automatizzati per le fasi di estrazione, allestimento piastre e rivelazione. RISULTATI: Le due metodiche hanno mostrato ottimi valori di concordanza tra loro; in particolare, la concordanza \ue8 stata del 98.4% per la determinazione delle infezioni da clamidia sulle urine e del 98.9% sui tamponi. Invece, la concordanza per le infezioni da gonococco \ue8 stata del 100% sulle urine e del 98.9% sui tamponi. La prevalenza di casi da N. gonorrhoeae nella popolazione afferente all\u2019ambulatorio MTS \ue8 risultata del 4%, mentre \ue8 stata pari allo 0.8% nella popolazione a minor rischio di infezioni sessualmente trasmesse. Infine, la prevalenza di C. trachomatis nella popolazione a pi\uf9 alto rischio \ue8 risultata pari al 9.1%, mentre nella la popolazione generale \ue8 stata del 2.4%. CONCLUSIONI: Il nostro studio conferma le ottime performance diagnostiche dei test BD ProbeTec CT/GC Qx DNA Amplified assay su piattaforma BD Viper LT e VERSANT CT/GC DNA 1.0 Assay, entrambi altamente automatizzati e di facile impego per gli utilizzatori

Pruritic papular eruption in HIV: A case successfully treated with NB-UVB

Abstact Pruritic papular eruption (PPE) is a skin disease characterized by the eruption of itching papules on the extremities, face, and trunk; it is quite frequent in HIV-positive patients especially during the advanced immunosuppressive stage. PPE usually improves or heals when antiretroviral therapy restores the immune system function, but in some cases, it can take several months, and a symptomatic treatment for PPE is required. Systemic antihistamines, topical steroids, topical tacrolimus, itraconazole, pentoxyphilline, and ultraviolet B phototherapy have been proposed in cases of persisting PPE, but an elective treatment has not yet been found. We describe the case of a black patient affected by PPE, nonimproving with antiretroviral treatment, and resistant to topical steroids and oral antihistamines; a satisfactory and speedy result was achieved with narrow-band ultraviolet B phototherapy. © 2013 Wiley Periodicals, Inc

In Vitro Activities of Several Antimicrobial Agents against Recently Isolated and Genotyped Chlamydia trachomatis Urogenital Serovars D through K▿

A systematic evaluation of the susceptibility of all Chlamydia trachomatis urogenital serovars (D through K) to levofloxacin, erythromycin, doxycycline, clarithromycin, and azithromycin was performed. All C. trachomatis serovars had comparable susceptibilities with respect to the various antimicrobials tested, thus confirming the homogeneous data so far obtained regarding the susceptibility of C. trachomatis to antimicrobial agents

Can a single drug administration elicit two different immunological pathways at the same time? A case report of Fixed Drug Eruption after anaphylaxis

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