Detection of ureaplasma urealyticum by polymerase chain reaction examination in nonspecific genital infection patients

Non specific genital infection (NSGI) is a condition affecting females which causes inflammation of the endocervix or anterior urethra that is not caused by Neisseria gonorrhoeae. The causative sexually transmitted organisms include Chlamydia trachomatis (Groups D to K) and Ureaplasma urealyticum. Infection caused by Ureaplasma urealyticum is often asymptomatic even though many studies have pronounced that Ureaplasma urealyticum can contribute not only to lower genitourinary infection but also to infertility. Ureaplasma urealyticum cannot be stained by Gram stain due to the lack of a cell wall of the organism. This research aims to evaluate the prevalence of Ureaplasma urealyticum in NSGI patients by using the polymerase chain reaction (PCR) method targeted in the ureaplasma gene structure 429 bp area. The samples were extracted from eighteen DNA NSGI patients. Eleven out of eighteen (61.11%) DNA NSGI samples tested positive for Ureaplasma urealyticum. Most patients (44.44%) with Ureaplasma urealyticum were unemployed, and 27.78% were complaining of recurrent vaginal discharge. The high incidence of Ureaplasma urealyticum in this study needs further attention since doxycycline remains the drug of choice of NSGI. Moxifloxacin should be considered for patients who are making no clinical progress with doxycycline

Profile of Condylomata Acuminata in Patients with HIV/AIDS

Background: Condylomata acuminata is human papilloma virus (HPV) infection, and one of the most common sexually transmitted disease, characterized with papul or papillomatous nodul in genital, perineum and anal, this disease can be asymptomatic as well. Some study proved sexually transmitted infection increase the incidence of Human immunodeficiency virus (HIV)/ acquired immunodeficiency syndrome (AIDS), and vice versa. Purpose: To evaluate the profile of condylomata acuminata in HIV/AIDS patients. Methods: Retrospective study of the incident of condylomata acuminata in HIV/AIDS patients using medical record within 4 years period from 2011 to 2014. Results: HIV/AIDS patients in outpatient clinic intermediate care infection disease unit RSUD Dr.Soetomo Surabaya in period 2011-2014 is 4057 patients, 63 (1.15%) of it with condylomata acuminata. HIV/AIDS patients with condylomata acuminata at the age group 25-44 (69.8%), the most sexual partner is heterosexual (58.7%), CD4+ count group mostly shown < 200/mm3 (46.0%), most of the patients got antiretroviral therapy (ART) as 66.7%, the most therapy for condylomata acuminata is trichloracetic acid (TCA) with fucidic acid (98.4%), most of the patient through 1-3 times therapy (50.8%), and the result is mostly not yet healed (76.2%). Conclusion: Most of condylomata acuminata patient in outpatient clinic intermediate care infection disease unit (UPIPI) got ART, TCA, and fucidic acid, and not complete resolution

The Use of Thalidomide in Steroid Dependent Continous Erythema Nodosum Leprosum Leprosy Patient: A Case Report

Background: Treatment thalidomide in erythema nodosum leprosum (ENL), can inhibits the transcription repression mediated by tumor necroting factor (TNF). Thalidomide can be used as sparing agents drug to reduce the dependency of steroid. Purpose: To report the effectiveness of thalidomide to treat ENL and of relinquish steroid dependency. Case: A 39 years old patient with leprosy borderline lepromatous type, came with complain bumps on skin accompanied with fever, occurring recurrently since 4 years ago if the steroid’s dose tappered off. He consumed steroid routinely every day for the last 4 years and if the dose was tapered to 4 mg once daily, the painful bumps reappeared often accompanied by fever. Thalidomide 50 mg twice daily and methyl prednisolone 4 mg once daily was given. The constant tapering off of methyl prednisolone done every week. After a month, the patient shown significant improvement. Discussion: Thalidomide is effective in ENL, it is regarded as first line in terms of clinical efficiency because it displays an effect on 90% of ENL patients. In this case, thalidomide was given and steroid dose was reduced slowly while observing the clinical manifestation and patient’s complain. There were no complain of recurrent ENL after discontinuation of steroid and thalidomide, no serious adverse event happened in this patient as well. Conclusion: The effectiveness of thalidomide in ENL is primarily due to its action on TNF but other mechanisms may contribute to its anti-inflammatory effect. Thalidomide is effective in the management of steroid dependent ENL patient.   Key words: thalidomide, steroid dependent, methyl prednisolone, erythema nodosum leprosu

Polymerase chain reaction chlamydia trachomatis examination in nonspecific genital infection patients

Introduction: Nonspecific genital infection (NSGI) is an inflammation of urethra, rectum, or cervix that caused by nonspecific bacteria. Chlamydia trachomatis is known as the most causal organism of NSGI, usually mild (mucopurulent discharge) or asymptomatic, and if untreated it can cause serious complication such as pelvic inflammatory disease that leads to infertility in women. The diagnosis of Chlamydia trachomatis needs an advanced method, such as polymerase chain reaction (PCR). PCR has high sensitivity and specificity, and endocervical swab is specimen of choice that also has high sensitivity and specificity to diagnose Chlamydia trachomatis. Method: This research aims to evaluate if Chlamydia trachomatis is the most causal organism of NSGI by PCR Chlamydia trachomatis using 201bp primers. Results: Eighteen NSGI married patients who came to outpatient clinic were evaluated from endocervical swab. The result demonstrated that 16,67% from eighteen NSGI patient positive Chlamydia trachomatis. Conclusion: The low incidence of Chlamydia trachomatis in low risk population such in this study need further study, the cause of NSGI needs to be known certainly so the exact treatment can be given

PEMERIKSAAN POLYMERASE CHAIN REACTION (PCR) CHLAMYDIA TRACHOMATIS PADA PASIEN INFEKSI GENITAL NONSPESIFIK

Background: Non specific genital infection was currently known mostly caused by Chlamydia trachomatis. Chlamydia trachomatis infection that left undiagnosed and untreated may cause serious complications such as infertility and pelvic inflammatory disease in women. To establish the diagnose of Chlamydia trachomatis infection need advance diagnostic method. One of the diagnostic method used to detect Chlamydia trachomatis is with nucleic acid amplification tests which PCR is the most recognized method that has high sensitivity and specificity than other methods. Purpose: to acknowledge prevalence of Chlamydia trachomatis among Non specific genital infection by polymerase chain reaction. Methods: in this cross sectional study, endocervical swab from 18 married women diagnosed with non specific genital infection were performed PCR Chlamydia trachomatis with 201bp. Results: 3 (16,67%) from 18 non specific genital infection patients were deteceted Chlamydia trachomatis. Conclusions: 16,67% non specific genital infection were detected Chlamydia trachomatis