International journal of STD & AIDS
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Practice Guideline
European guideline for the management of scabies, 2010.
Transmission of the mite Sarcoptes scabiei generally occurs by protracted direct body contact; although in crusted scabies, transmission also occurs via infected clothing or bedding. Diagnosis is usually clinical and topical antiscabietics are the mainstay of treatment. Oral ivermectin is not licensed in most countries, but may have a role in certain patients. Treatment of sexual contacts is indicated.
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Case Reports
Cefixime-resistant Neisseria gonorrhoeae in the UK: a time to reflect on practice and recommendations.
A 40-year-old man who has sex with men (MSM) with urethral gonorrhoea failed to respond to treatment with 400 mg cefixime orally. Laboratory isolation of the post-treatment strain showed a minimum inhibitory concentration of ≥0.25 mg/L, which is a level of tolerance to cefixime that has not been previously documented in the UK. ⋯ It is vital that gonorrhoea culture continues to be attempted from all infected individuals to enable accurate diagnosis and antibiotic sensitivities. We also recommend that laboratories test for cefixime sensitivity routinely, given that it is one of the most commonly prescribed treatments for gonorrhoea.
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Cryptococcal meningitis (CM) is a major cause of death among HIV-infected persons in sub-Saharan Africa. We conducted a study to describe the long-term outcomes during the pre-antiretroviral post-ART therapy period. Enrolled cases were those detected through population-based surveillance in Gauteng Province, South Africa, and diagnosed during March-November 2002 and July-September 2003 from eight large hospitals representing academic, provincial and rural settings. ⋯ On Cox proportional hazards multivariable analysis, severe disease was associated with shorter survival time; having received any antifungal treatment for the cryptococcal episode was associated with increased survival time at follow-up. Although most patients in this cohort survived the initial hospitalization, only 41% were still alive three months after diagnosis, with nearly half of deaths occurring outside a hospital. These data are an important baseline from which to measure effectiveness of public health management of CM in South Africa.
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Randomized Controlled Trial
The relative contribution of viral and bacterial sexually transmitted infections on HIV acquisition in southern African women in the Methods for Improving Reproductive Health in Africa study.
We assess the relative contribution of viral and bacterial sexually transmitted infections (STIs) on HIV acquisition among southern African women in a nested case-control study within the Methods for Improving Reproductive Health in Africa (MIRA) trial. Cases were women with incident HIV infection; controls were HIV-uninfected at the time of case seroconversion selected in a 1 to 3 case to control ratio (risk-set sampling), matched on study site and time of follow-up. Conditional logistic regression models were used to calculate adjusted odds ratios (AORs) and population-attributable fractions (PAF). ⋯ The adjusted PAF of HIV incidence for prevalent HSV-2 was 29.0% (95% CI: 16.8-39.3), for incident HSV-2 2.1% (95% CI: 0.6-3.6) and for incident N. gonorrhoeae 4.1% (95% CI: 2.5-5.8). Women's greatest risk factors for HIV acquisition were incident bacterial and viral STIs. Women-centred interventions aimed at decreasing HIV incidence in young African women need to address these common co-morbid conditions.
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Myiasis is infestation of skin, mucosa, orifices or natural cavities of humans or animals by larvae of flying dipterous insects that, at least for a certain period of their life cycle, feed from live or necrotic tissue of the host. The distribution is worldwide with more cases being reported from tropical, subtropical and warm temperate areas. This report describes a rare case of perianal condylomata acuminata complicated with myiasis due to Chrysomya bezziana, seen in the presence of poor hygiene in a tropical country with a high fly population.