Posts filed under ‘Infecciones de transmision sexual’
ICSI for treatment of human immunodeficiency virus and hepatitis C virus-serodiscordant couples with infected male partner.
Hum Reprod. 2005 Aug;20(8):2242-6.
Mencaglia L, Falcone P, Lentini GM, Consigli S, Pisoni M, Lofiego V, Guidetti R, Piomboni P, De Leo V.
Centro di Chirurgia Ambulatoriale SrL, Via Toselle 178, 50144, Florence, Italy.
Assisted reproductive technology with semen washing can offer a significant reduction in risk of sexual and vertical transmission of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) in serodiscordant couples with infected male partner.
Among couples coming to our centre for reproductive problems from January 2001 to December 2003, we selected 43 couples with seropositive male and seronegative female: 25 couples with HIV-seropositive males, 10 couples with HIV/hepatitis C virus (HCV)-seropositive males and eight couples with HCV-seropositive males. Sperm samples were washed and used for ICSI.
Seventy-eight cycles of ICSI were performed. The mean fertilization rate was 70.34 +/- 20.14% (mean +/- SD). A mean number of 3.55 +/- 1.11 (range: 1-5) embryos of good quality was transferred for each patient. We obtained 22 pregnancies (21 singletons and one twin), with a pregnancy rate per transfer of 28.2% and an implantation rate per transfer of 15.2%. The cumulative pregnancy rate was 51.2%. At follow-up, no seroconversion was detected in any patient.
Our data suggest that sperm wash and ICSI could be useful for reducing the risk of HIV and/or HCV transmission in serodiscordant couples with infected male wishing to have a child, irrespective of their fertility status.
Treatment failure of pharyngeal gonorrhoea with internationally recommended first-line ceftriaxone verified in Slovenia, September 2011.
Euro Surveill. 2012 Jun 21;17(25).
Unemo M, Golparian D, Potočnik M, Jeverica S.
World Health Organization Collaborating Centre for Gonorrhoea and other Sexually Transmitted Infections, Swedish Reference Laboratory for Pathogenic Neisseria, Department of Laboratory Medicine, Microbiology, Örebro University Hospital, Örebro, Sweden. firstname.lastname@example.org
We describe the second case in Europe of verified treatment failure of pharyngeal gonorrhoea, caused by an internationally occurring multidrug-resistant gonococcal clone, with recommended first-line ceftriaxone 250 mg in Slovenia. This is of grave concern since ceftriaxone is last remaining option for empirical treatment. Increased awareness of ceftriaxone failures, more frequent test-of-cure, strict adherence to regularly updated treatment guidelines, and thorough verification/falsification of suspected treatment failures are essential globally. New effective treatment options are imperative.
The 2012 European guideline on the diagnosis and treatment of gonorrhoea in adults recommends dual antimicrobial therapy.
Euro Surveill. 2012 Nov 22;17(47).
Unemo M; European STI Guidelines Editorial Board.
Expert Rev Anti Infect Ther. 2012 Aug;10(8):831-3.
Kidd S, Kirkcaldy R, Weinstock H, Bolan G.
Update to CDC’s Sexually transmitted diseases treatment guidelines, 2010: oral cephalosporins no longer a recommended treatment for gonococcal infections.
MMWR Morb Mortal Wkly Rep. 2012 Aug 10;61(31):590-4.
Centers for Disease Control and Prevention (CDC).
Gonorrhea is a major cause of serious reproductive complications in women and can facilitate human immunodeficiency virus (HIV) transmission. Effective treatment is a cornerstone of U.S. gonorrhea control efforts, but treatment of gonorrhea has been complicated by the ability of Neisseria gonorrhoeae to develop antimicrobial resistance. This report, using data from CDC’s Gonococcal Isolate Surveillance Project (GISP), describes laboratory evidence of declining cefixime susceptibility among urethral N. gonorrhoeae isolates collected in the United States during 2006-2011 and updates CDC’s current recommendations for treatment of gonorrhea. Based on GISP data, CDC recommends combination therapy with ceftriaxone 250 mg intramuscularly and either azithromycin 1 g orally as a single dose or doxycycline 100 mg orally twice daily for 7 days as the most reliably effective treatment for uncomplicated gonorrhea. CDC no longer recommends cefixime at any dose as a first-line regimen for treatment of gonococcal infections. If cefixime is used as an alternative agent, then the patient should return in 1 week for a test-of-cure at the site of infection.
PDF (see pag. 590)
N Engl J of Medicine Feb.7, 2013 V.368 P.561
IMAGES IN CLINICAL MEDICINE
Birgit Ziegler, M.D., and Nina Booken, M.D.- University Hospital of Mannheim, Mannheim, Germany
A 52-year-old woman presented with a 3-week history of asymptomatic erythematous papules and nodules. The lesions initially appeared on the face and tongue (Panels A and B) and subsequently spread to the trunk and lower legs. The patient had no other systemic symptoms. Two weeks earlier, she had been treated with oral penicillin G for a sore throat but had stopped taking the antibiotic after a few days because of angioedema. A biopsy of a facial lesion revealed an inflammatory infiltrate with multiple mature plasma cells suggestive of secondary syphilis. The diagnosis was made on the basis of a titer of 1:160,000 (normal range, 0 to 640) on a Treponema pallidum particle agglutination assay, a value of 5770 U per milliliter (normal range, 0 to 24) on an enzyme-linked immunosorbent assay for T. pallidum IgG, and a positive assay for T. pallidum IgM. The differential diagnosis included leukemia cutis and cutaneous sarcoidosis. The patient received the diagnosis of papulonodular secondary syphilis with mucous plaques and most likely a syphilitic pharyngitis. Because of previous penicillin intolerance, the patient was treated with intravenous ceftriaxone (2 g daily) for 3 weeks. The rash cleared within 4 weeks after the initiation of treatment.
Rev Chilena Infectol. 2010 Dec;27(6):525-32.
Romero C P, Urzúa S C, Gallardo V P, Verdaguer T J, Lechuga C M, Hernández N H, Sanhueza Z F, Andaur L M, Donaire V E.
Servicio de Oftalmología, Hospital Clínico, Universidad de Chile, Santiago, Chile. email@example.com
Ocular manifestations in patients with syphilis may involve almost any of the structures of the eye.
To describe ten new cases of syphilis with eye involvement and to briefly discuss the management and therapy of such condition.
MATERIAL AND METHODS:
Ten cases were retrospectively studied over 13 years. Demographic factors, ophthalmologic examination, and laboratory tests were assessed.
Seven of the 10 cases were male and 3 were female. The mean age of patients was 39,7 years. Disease presentation included: panuveitis (6 patients), optic neuritis (3), retinal vasculitis (1) and Argyll-Robertson pupil (1). Cerebrospinal fluid VDRL test was positive in 6 patients and 3 patients were HIV (+).
Syphilis is able to display diverse ophthalmologic manifestations. Not in all the cases the CSF-VDRL test was positive. Antitreponemal therapy generates a fast and effective response in the affected patients.