Non-specific Genital Infection Research Articles

Recurrent Genital Herpes and Balanoposthitis Candidiasis in Men with Incomplete Circumcision: A Case Report

Background: Circumcision can reduce the risk of sexually transmitted diseases (STDs). It may reduce males acquiring HSV-2 by 30% and 68% lower prevalence of balanitis than uncircumcised males. There is no report of incomplete circumcision as a risk for STD infection.
 Case presentation: A 31-year-old male complained of multiple ulcers that covered a yellowish crust on the penile with a burning sensation since 7 days ago. Initially, it was vesicles that turned into ulcers. One month ago, he complained of moist scales on his preputium that felt itchy and smelly. The patient is married and sexually active. History of intercourse with female sex workers without condoms 2 weeks ago. The patient had incomplete circumcision when he was a child; the preputium is still persistent and seldom cleaned regularly. One year ago, there was a history of vesicles on the penis. Physical examination revealed obesity grade 2. Venereological findings showed a whitish pseudo-membrane on the preputium, glans penis, and ulcers in various sizes covered pseudo-membrane surrounded erythema oedema. Laboratory revealed positive IgG HSV1, IgM, and IgG HSV2. A fungal culture is positive candida. Diagnosis established as recurrent genital herpes, balanoposthitis candidiasis, non-specific genital infection, candidiasis intertrigo. The patient has persistent preputium as the entry of commensal pathogens through abrasions in the mucosa, which causes infection. The patient had complete resolution after being administered oral acyclovir, doxycycline, and topical miconazole.
 Conclusion: Persistent preputium in incomplete circumcision is a risk for developing candidiasis, balanoposthitis, and recurrent genital herpes.

A Case Report of Cervicitis Gonorrhea

Background: Gonorrhea refers to a set of clinical conditions involving infection with the sexually acquired bacterial pathogen, Neisseria gonorrhoeae. One of the simplest gonococcal infections in women involves mucosal surfaces of the endocervix that cause cervicitis, a frequently asymptomatic inflammatory condition that results in an abnormal mucopurulent discharge and cervical friability. Purpose: To report a case of cervicitis gonorrhea in a female patient whose sexual partner had a hisstory of unprotected promiscuous intercource with multiple sex worker. Case: A 24-year-old female patient presented with increased vaginal discharge for 4 days. Her husband had a history of having sexual intercourse with a sex worker 8 days before. Physical examination revealed mucopurulent exudate in the genitalia and endocervical canal. The Gram staining showed numerous leucocytes and Gram-negative intracellular diplococci, while the result of polymerase chain reaction (PCR) examination for Chlamydia trachomatis was negative. The patient was treated with single-dose cefixime 400 mg orally and doxycycline 100 mg orally twice a day for 7 days. Discussion: The present case report showed cervicitis gonorrhea co-infected with a nonspecific genital infection that was felt asymptomatic and unintentionally found when the patient accompanied her husband to Sexually Transmitted Infection (STI) clinic. The presumptive treatment of cervicitis directed against N. gonorrhoeae and C. trachomatis in this patient leads to a complete cure of the disease. Conclusion: It is important to treat the sexual partner of a patient with urethritis gonorrhea. The empiric treatment of cervicitis that is directed against N. gonorrhoeae and also against C. trachomatis is mandatory in preventing further possible complications.

Management of Non-Specific Genital Infections in Infertile Crossbred Cattle

Among 1046 infertile breedable bovines screened in different sexual health camps in and around Anand district during one year, the prevalence of repeat breeding and genital infection was found to be 17.97 and 17.11 %, respectively. The representative 23 HF crossbred infertile cows from within Anand taluka were selected for cultural examination, antibiotics sensitivity of isolates and accordingly, the treatment and pregnancy follow up. The cultural isolation of CVM/genital discharges from 23 crossbred cows revealed bacterial growth in 65.22 (15) % samples; the Gram +ve Bacilli Spp. was prevalent to the highest extent (38.10%; 8) followed by Corynebacterium Spp. (23.81%, 5). All the isolates (100 %) were sensitive to enrofloxacin followed by cefotaxime and tetracycline (73.33% each), while they were resistant to tyrosin. Among the culturally positive cases, use of effective drugs resulted in overall three cycles pregnancy rate of 86.66 (13/15) %, while in culturally sterile cases it was 50 (4/8)%, showing the utility of antibiotics sensitivity testing in managing infertile animals.

Concurrent infections of Trichomoniasis and nongonococcal cervicitis in a menopausal woman: a case report

Background: Trichomoniasis is a rare, sexually transmitted infection. Trichomoniasis can often coincide with other pathogens that cause genital infections. Menopausal women remain at risk of developing this disease due to physiological and anatomical changes in the female genital organs.Case: A woman, age 61 years, experience vaginal discharge from one month with itching in the genital area. The last menstruation period was 7 years ago. The patient had one sexual intercourse a month ago with her boyfriend; it was the first sexual contact since 7 years ago, without using a condom.Result: Pelvic examination reveal vaginal wall erythema, yellowish discharge on the fornix posterior, and cervical, watery consistency. Leukocytes 20-25 per field view and Trichomonas vaginalis was found on laboratory examination. pH examination on the vagina was 8. The patient was diagnosed with Trichomoniasis, and nongonococcal cervicitis was given metronidazole 2 x 500 mg, azithromycin 1000 mg single dose for therapy. After therapy with metronidazole, there is an increase in pH that occurred a week after therapy, which amounted to 10 and decreased one week later to 8. An increase in leukocytes also accompanied increased pH in cases, so that co-infection with other germs should be considered. Conclusion: Examination of wet vaginal preparations revealed trichomonas vaginalis that are alive and moving. In follow-up observations, there was an increase in vaginal pH and increased leukocytes in the vaginal gram. Specific causative bacteria were not found, and thus, the patient was diagnosed with a non-specific genital infection on further observation.

The association between region of birth and sexually transmitted infections among people of black Caribbean ethnicity attending sexual health services in England, 2015.

Background/IntroductionIn England, people of Black Caribbean (BC) ethnicity are disproportionately affected by sexually transmitted infections (STIs), but it is unclear whether this varies by their region of birth.Aim(s)/ObjectivesTo examine differences in STI diagnoses among UK- and Caribbean-born BC people.MethodsData on STI diagnoses in BC people attending specialist sexual health services (SHSs) during 2015 and living in England were obtained from the GUMCAD STI surveillance system, the national surveillance system for STIs in England. Associations between being UK- or Caribbean-born and each of several STI diagnoses were examined, using univariate and multivariable generalised estimated equations logistic regression models adjusted for sexual orientation, place of residence (London vs. non-London), HIV status, area-level deprivation, and STI diagnosis in the last year. All analyses were stratified by age (<25 vs. ≥25 years).ResultsIn 2015, 63,568 BC people made 108,881 attendances at specialist SHSs; 81.9% of these attendances were made by UK-born BCs. The median age (years) was 26 for UK-born and 35 for Caribbean-born people (p≤0.001). Chlamydia, gonorrhoea and non-specific genital infection (NSGI) were the most commonly diagnosed STIs among UK- (5.8%, 2.1% and 2.8%) and Caribbean-born people (4.5%, 1.7% and 3.5%) respectively. Among BCs aged under 25, no significant differences in STIs were found between UK- and Caribbean-born people. Among BCs aged ≥25, compared to Caribbean-born people, those who were UK-born were more likely to be diagnosed with chlamydia (AOR 1.15 [95%C.I. 1.04–1.27]); gonorrhoea (AOR 1.23 [95%C.I. 1.06–1.45]) and genital herpes (AOR 1.23 [95% C.I. 1.10–1.56]) and less likely to be diagnosed with NSGI (AOR 0.89 [95% C.I. 0.80–0.99]) and Trichomoniasis (AOR 0.84 [95% C.I. 0.71–0.99]).Discussion/ConclusionSTI diagnoses in BC people aged ≥25 attending specialist SHSs vary by region of birth. Country of birth may have an influence on social and sexual networks and therefore transmission of STIs.

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.

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.

Health-related quality of life and psychosocial impacts of a diagnosis of non-specific genital infection in symptomatic heterosexual men attending UK sexual health clinics: a feasibility study

IntroductionNon-specific genital infection (NSGI; non-Chlamydia trachomatis, non-Neisseria gonorrhoeae-associated urethritis) is a common diagnosis in symptomatic heterosexual men attending UK sexual health clinics (SHCs). but little is known about the psychosocial...

P056 Influence of country of birth on risk of STI diagnosis among black Caribbeans in England in 2014

Background/introduction In England, people of Black Caribbean (BC) ethnicity are disproportionately affected by sexually transmitted infections (STIs), but it is unclear whether this is associated with their country of birth. Aim(s)/objectives To examine differences in STI diagnoses among UK- and Caribbean-born BC people. Methods Data on STI diagnoses in BC people attending genitourinary medicine (GUM) clinics and living in England were obtained from the GUM Clinic Activity Dataset (GUMCADv2). Associations between being UK- or Caribbean-born and diagnosis with an STI were derived using univariate and multivariable multilevel logistic regression models adjusted for age, gender/sexual-orientation, residence, and HIV status. Results BC people made 231,719 attendances in 2014; 81.9% were UK-born. The median age (years) was 25 for UK-born and 34 for Caribbean-born people (p ≤ 0.001). Chlamydia, non-specific genital infection and gonorrhoea were the most commonly diagnosed STIs among UK- (37.4%, 19.5% and 13.7%) and Caribbean-born attendees (32.1%, 25.2% and 13.1%). From the multilevel analysis, UK-born attendees were less likely to be diagnosed with chlamydia (aOR 0.87 [95%C.I. 0.81–0.94]) and trichomoniasis (0.83 [0.71–0.97]), and more likely to be diagnosed with genital warts (1.24 [1.07–1.45]) than Caribbean-born attendees. The adjusted odds of a gonorrhoea diagnosis did not vary by country of birth. Discussion/conclusion STI rates among black Caribbeans attending GUM clinics in England are high and might be influenced by STI epidemiology in their country of birth. Studies on the effectiveness of interventions aimed at reducing the burden of STIs in all black Caribbeans are urgently needed.

Prevalence of Mycoplasma hominis and Ureaplasma urealyticum infection in female sex workers and its association with douching: A study in East Jakarta, Indonesia using Mycoplasma System Plus

Background: Mycoplasma hominis and Ureaplasma urealyticum are commonly involved in pathogenesis of bacterial vaginosis and non-specific genital infection, while doing vaginal douching also already known as predisposing factor. Methods: To evaluate the prevalence of Mycoplasma hominis and Ureaplasma urealyticum infection in female sex workers and its association with vaginal douching, we conducted a study through 180 female sex workers in East Jakarta, Indonesia. Vaginal fluid samples were collected from these women. It was revealed that most of the women used betel soap, baby soap, tooth paste, or herbal medicine as vaginal douching materials. The association of vaginal douching and prevalence of Mycoplasma hominis and Ureaplasma urealyticum was analyzed using cross sectional statistical methods. Results: There is a high prevalence of Mycoplasma hominis and Ureaplasma urealyticum infection (72%), but there are no association between vaginal douching practice and infection of Mycoplasma hominis and Ureaplasma urealyticum. Conclusions: The high prevalence of Mycoplasma hominis and Ureaplasma urealyticum infection in female sex workers in East Jakarta warrants a routine screening of these infections. Unusual1 materials used for vaginal douching in this study might cause the negative association between high prevalence of these bacteria with vaginal douching. Keywords: Mycoplasma hominis, Ureaplasma urealyticum, female sex workers, vaginal douching

Studies on Estrual Cervical Mucus of Repeat Breeding Cows with Special Reference to Ovulatory Disturbances and Genital Infection

A total of 100 crossbred Jersey cows comprising of 80 repeat breeder presented for treatment and 20 clinically healthy (control group) animals presented for artificial Insemination at their first service within 60–90 days following calving were selected. Estrual cervical mucus were examined for physical properties and white side test (WST). Effects of ovulatory disturbances and non specific bacterial genital infection on physical properties of cervical mucus were also determined. The volume, colour, consistency, stringiness, fern pattern and spinnbarkeit values of cervical mucus were not affected by ovulatory disturbances, while, colour, consistency and pH showed significant (p < 0.01) changes due to non-specific bacterial genital infection. The results of WST showed significant (p < 0.01) positive correlation (0.484) with bacterial culture. It is concluded that ovulatory disturbances have no impact on altering physical characteristics of estrual cervical mucus; however, colour, consistency and pH of cervical mucus are greatly influenced by nonspecific bacterial genital infection in repeat breeding cattle.

Chlamydia trachomatis infection: the efficacy and safety of a fast-track referral and treatment system

We introduced a Nurse/Health Advisor-led fast-track service for treating patients diagnosed with chlamydia outside a genitourinary medicine setting and contacts of chlamydia/non-specific urethritis/cervicitis wherever diagnosed. Asymptomatic patients were treated without initial testing and asked to return for full screening at four to six weeks. We assessed the efficacy and safety of the system and need for follow-up after treatment. Case-notes of 226 patients (121 men and 105 women) were analysed, of whom 140 attended follow-up. With the exception of one case of gonorrhoea, no other serious sexually transmitted infection was detected. Twenty-seven (19.2%) patients were re-treated for either chlamydia (six patients, 4.4%) or non-specific genital infection or because of having unprotected intercourse with untreated or partially treated partners. We conclude that in our relatively low-risk population, our fast-track service is safe and effective. Test of cure for chlamydia seems essential because of the high percentage of patients requiring re-treatment.

Where has all the chlamydia come from? The clinical impact of the introduction of an improved chlamydia test

At a time of increasing demands on genitourinary (GU) medicine clinics, the introduction of a new nucleic acid test to a GU medicine clinic has the potential to increase the workload due to increased numbers of patients being identified with chlamydia, and a consequent increase in partner notification. In one clinic setting, we found a doubling in the rates of chlamydial infection following the introduction of a new test, but a concomitant reduction in the rates of non-specific genital infection. The improved specificity of the test has made counselling of patients with chlamydia and non-specific infection much easier. An audit has shown that contact-tracing outcomes are significantly better in patients who are diagnosed with chlamydia.

A Case-Control Study of Risk Factors for Invasive Cervical Cancer among U.S. Women Exposed to Oncogenic Types of Human Papillomavirus

Abstract Oncogenic human papillomavirus (HPV) infections, the necessary cause of most cervical cancers, are common and usually clear within 1 to 2 years. Identifying cofactors that lead to cancer among HPV-infected women has depended mainly on case-control studies defining HPV by DNA testing. DNA testing assesses only current infection; thus, concerns about residual confounding remain. To assess cofactors, we used seropositivity to five oncogenic HPV types as a marker of past exposure and confined our analysis to seropositive controls compared with cancer cases. Study subjects had participated in a multicenter U.S. case-control study conducted in the early 1980s. The detailed questionnaire and stored sera for 235 cases of squamous carcinoma and 486 controls motivated the reanalysis. We measured antibodies to HPV types 16, 18, 31, 45, and 52. Independent, significant predictors of seropositivity among controls included numbers of sexual partners, Black race, and oral contraceptive use. Condom use was protective. Among HPV-exposed women, Papanicolaou screening, Black race, and yeast infection were significantly associated with reduced cancer risk. Current smoking was associated with a 2-fold increase in risk; there were independent, significant trends of increased risk with numbers of cigarettes smoked (P for trend = 0.003) and years of smoking (P for trend = 0.01). Other significant predictors of increased risk included low education and income and history of nonspecific genital infection. Unlike recent HPV DNA-based investigations, based on the use of HPV-seropositive controls in this study, oral contraceptive use was unrelated to the risk of cervical cancer and multiparity was only weakly related to risk. It is particularly worth considering further why studies of different designs are inconsistent regarding the effect of oral contraceptive use.

Characterizing patients with multiple sexually acquired infections: a multivariate analysis.

It has long been recognized that sexually transmitted diseases (STDs) may occur concurrently hence necessitating screening in individuals attending Genito-Urinary Medicine (GUM) clinics. However there are few data on individuals with more than one concurrent STD. Individuals attending the GUM Department in the Royal Infirmary of Edinburgh between 1990 and 1994 with the diagnosis of HIV infection, genital warts, genital herpes, non-specific genital infection (NSGI), gonorrhoea and syphilis were included in the study. A multivariate comparison was made between those presenting with multiple concurrent STDs and a control group comprising individuals with a solitary STD with respect to year of attendance, social class, location of acquisition of infection, sex, sexual orientation and age using a logistic regression model. A total of 680 of 9265 patients in the study period had more than one concurrent STD. Individuals in lower socio-economic class were at higher risk and older individuals at lower risk of multiple concurrent STDs. Multiple sexually acquired infections are common in individuals who attend GUM clinics. Age and socio-economic class were the only significant variables. Identification of populations at highest risk for multiple infection can direct interventions against all STDs.

Surveillance report: disease trends at New Zealand sexually transmitted disease clinics 1977-1993.

To document trends in sexually transmitted diseases (STDs) recorded by New Zealand STD Clinics from 1977-1993. Clinic disease figures have been recorded since clinics commenced in the 1920s and were recorded in a comprehensive format from the 1970s. The New Zealand Venereological Society has collated these data since 1986. The most common STDs in New Zealand clinics are genital warts, non-specific genital infections, chlamydia and genital herpes. Genital Wart infection has been the commonest STD diagnosed in clinics since 1988 and occurred in 17.9% of new patients in 1993. Non Specific Genital Infections were the commonest diagnosis from 1977 to 1988 affecting 17.5% of new patients in 1993. Chlamydia has shown a fall since the mid 1980s diagnosed in 5.4% of new patients in 1993 compared with 14.6% in 1986. Gonorrhoea incidence has fallen steadily since 1975 affecting only 1.1% new patients in 1993. Genital Herpes numbers tripled from 1977 to 1993 and 54% are primary cases. HIV Disease has increased clinic workload greatly with screening and counselling conducted in 25% of new patients in 1993. HIV disease was diagnosed or managed in 0.2% new clinic patients (49 cases). Syphilis has remained at a low incidence in New Zealand diagnosed in 0.3% new patients in 1993. Attendance for the viral diseases, HIV disease, genital warts and genital herpes is increasing while for the bacterial diseases, gonorrhoea and chlamydia is decreasing. The rise in disease numbers since 1990 may be due to meeting service needs rather than a true rise in disease incidence. STD surveillance in New Zealand is improving with new reporting systems being developed.

The national STD surveillance system in Italy: results of the first year of activity. STD Surveillance Working Group.

A prospective STD surveillance system was developed in Italy in 1990. Newly diagnosed cases of sexually transmitted disease (STD) are reported by a network of 45 sentinel STD clinics throughout the country. A total of 10,253 patients were reported between September 1990 and December 1991. The most frequent diagnoses were genital warts (30.8%), non-specific genital infection (male) (12.8%), and non-specific genital infection (female) (11.5%). All patients were asked to undergo an HIV test; 68.4% accepted, of whom 9.3% were seropositive. During the 16-month study period HIV prevalence decreased among IDUs and homo-bisexuals, but increased among non-IDU heterosexuals. These data suggest that STD patients may represent a useful early warning system to detect changes in the epidemic and in the spread of the virus among low-risk heterosexuals. A better counselling programme is needed to improve the acceptance rate of HIV testing among STD patients, and to draw more attention to at-risk sexual behaviours.

Patterns of risk behaviour for patients with sexually transmitted diseases and surveillance for human immunodeficiency virus in Kuala Lumpur, Malaysia.

A study was conducted to determine the feasibility of establishing a sentinel human immunodeficiency virus (HIV) surveillance system involving patients with sexually transmitted diseases attending private clinics and a government sexually transmitted disease clinic in Kuala Lumpur, Malaysia. Information on risk behaviours for HIV infection were also collected. A total of 84 female and 91 male patients were interviewed and tested for HIV infection; 41.7% of the women reported working as prostitutes, other occupations included masseuses, hairdressers, waitresses, salesgirls, receptionists, factory workers, and others. The most common diagnosis was gonorrhoea. Other diagnoses included non-specific genital infection, pelvic inflammatory disease, genital herpes and syphilis. 58.3% of the women had a hundred or more sex partners during the previous month; 99% had 6 or more sex partners. Only 4.8% of female patients had their male partners using condoms most of the time, 11.9% hardly used condoms at all. Of the males, 93.3% were heterosexual, while 6.7% were bisexuals, 41.1% had between 6-20 different partners in the previous year. 78.0% of them had prostitutes as their sex partners most of the time. 41.8% had experiences in Thailand and the Philippines. 73.6% never used condoms, while 19.8% only used condoms rarely. Although all patients were tested negative for HIV antibodies, lot quality assurance sampling methods indicate that the upper limits of prevalences for females and males were 3.5% and 3.3% respectively, at a 5% type I error. The study has shown that it is feasible to carry out a sentinel surveillance programme among STD patients and provided useful baseline data for future comparisons.(ABSTRACT TRUNCATED AT 250 WORDS)

Candidosis of the Genital Tract in Non-pregnant Women

Of 300 non-pregnant women seen in an STD clinic, 94 (31.3%) harboured C. albicans or C. glabrata in the genital tract; 84 of these women (89.4%) had at least one moderate or marked symptom or clinical sign. Of the 94 women with Candida, 50 had another genital infection; 38% of these 50 women had at least one moderate or marked symptom or clinical sign, compared with 75% of the 44 women with no other infection. This difference is significant. Of the 146 women taking oral contraceptives, 51 (34.9%) had Candida, compared with 43 (27.9%) of the 154 women who were not. The incidence of trichomoniasis, anaerobic vaginitis and non-specific genital infection was lower among women with Candida than among the others.

Candidosis of the genital tract in non-pregnant women

Of 300 non-pregnant women seen in an STD clinic, 94 (31.3%) harboured C. albicans or C. glabrata in the genital tract; 84 of these women (89.4%) had at least one moderate or marked symptom or clinical sign. Of the 94 women with Candida, 50 had another genital infection; 38% of these 50 women had at least one moderate or marked symptom or clinical sign, compared with 75% of the 44 women with no other infection. This difference is significant. Of the 146 women taking oral contraceptives, 51 (34.9%) had Candida, compared with 43 (27.9%) of the 154 women who were not. The incidence of trichomoniasis, anaerobic vaginitis and non-specific genital infection was lower among women with Candida than among the others.