International journal of STD & AIDS
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When no demonstrable cause is uncovered after excluding inflammatory dermatosis, infectious disease or a manifestation of anorectal disease, anogenital pruritus is often described as 'idiopathic'. Lumbosacral radiculopathy was described by Cohen et al. as one of the possible causes of 'idiopathic' anogenital pruritus. ⋯ This is, to the best of our knowledge, the first case of neuropathic scrotal pruritus secondary to direct nerve compression by an inguinal hernia. We propose that a proper examination for the presence of inguinal hernia be performed in the work-up for scrotal pruritus.
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The objective was to determine the occurrence of four urethral pathogens in urine specimens from symptomatic men using transcription mediated amplification (TMA) assay. Urethral swab and urine specimens from 300 men presenting to a family practitioner were Gram stained and tested for Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis and Mycoplasma genitalium using three TMA assays respectively. Except for T. vaginalis, the other recognized pathogens viz. ⋯ This study demonstrated that in symptomatic men attending family practice, M. genitalium and T. vaginalis are also important aetiological agents of urethritis and hence treatment strategies be they syndromic management or laboratory directed should cover for these causative agents. The microscopic diagnosis of urethritis may not be important for treatment strategies. The current syndromic treatment guidelines for developing countries including South Africa need modification.
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Pneumocystis jirovecii pneumonia (PCP) prophylaxis may be discontinued when CD4 is > or =200 cells/mm(3) for three months in response to highly active antiretroviral therapy (HAART). Unlike CD4, the total lymphocyte count (TLC) is inexpensive and widely available in resource-constrained countries. Paired TLC and CD4 values of HIV-infected patients attending an HIV clinic from 1998 to 2005 were analysed by Spearman's correlation. ⋯ The area under the ROC curve was 0.85 (95% CI = 0.85-0.86). In the historical cohort analysis, 85% and 70% of subjects who achieved TLC > or = 2000 cells/mm(3) and > or =1400, respectively, had a corresponding CD4 > or = 200 cells/mm(3). A sustained rise in TLC in response to HAART may potentially serve as a criterion for discontinuing PCP prophylaxis in resource-constrained countries.