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Edwards RJ, Edwards J, Boyce GG. Clinical Features and Follow-Up of the First Two Cases of Mpox From Trinidad and Tobago. Cureus 2024; 16:e53149. [PMID: 38420056 PMCID: PMC10900284 DOI: 10.7759/cureus.53149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Mpox is a viral zoonotic disease that is endemic in Central and West Africa and belongs to the Orthopoxvirus genus. A global outbreak of mpox began in May 2022, mainly due to the transmission of the clade 11b virus through person-to-person contact with the lesions or scabs of a person infected with mpox. The data on mpox infection in the Caribbean is sparse. Here we report the clinical features and follow-up of the first two confirmed cases of mpox in Trinidad and Tobago (T&T). Both patients were men who have sex with men (MSM) who presented with genital lesions and expressed concern about increased stigma towards their already marginalized community.
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Affiliation(s)
- Robert Jeffrey Edwards
- Human Immunodeficiency Virus (HIV), Medical Research Foundation of Trinidad and Tobago, Port of Spain, TTO
| | - Jonathan Edwards
- Human Immunodeficiency Virus (HIV), Medical Research Foundation of Trinidad and Tobago, Port of Spain, TTO
| | - Gregory G Boyce
- Human Immunodeficiency Virus (HIV), Medical Research Foundation of Trinidad and Tobago, Port of Spain, TTO
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2
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Eguiluz M, Qquellon J, Vargas SK, Reyes-Diaz M, Konda KA, Caceres CF, Klausner JD. Molecular Characterization of Genital and Extra genital Lesions With the PlexPCR VHS Assay in Patients Diagnosed With Syphilis. Open Forum Infect Dis 2023; 10:ofad483. [PMID: 37869408 PMCID: PMC10588620 DOI: 10.1093/ofid/ofad483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 09/19/2023] [Indexed: 10/24/2023] Open
Abstract
Background Syphilis diagnosis relies on immunologic markers and clinical protocols. However, syphilitic lesions can be confused with other genital ulcer diseases. Methods Using a PlexPCR VHS assay, we analyzed lesion DNA samples from 87 individuals who were clinically diagnosed with early syphilis infection and had at least 1 positive serologic test result. DNA was detected by the PlexPCR VHS multiplex assay and β-globin genes. Results Among the participants, 99% (86/87) had a positive rapid treponemal test result. DNA was successfully detected in 91% (79/87) of the lesion samples. PlexPCR VHS identified 5 herpes simplex virus (HSV)/Treponema pallidum coinfections (2 HSV-1 and 3 HSV-2), only T pallidum DNA in 62% (49/79), and only HSV-2 in 12.7% (10/79). While 19% (15/79) were negative for all pathogens, none were varicella zoster virus positive. The PlexPCR VHS had 68.4% agreement with the clinical diagnosis. Conclusions Since the PlexPCR VHS detects multiple organisms simultaneously, it can help to confirm actual syphilis and identify other pathogen coinfections or the pathogen causing the ulcer.
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Affiliation(s)
- Maria Eguiluz
- Center for Interdisciplinary Studies in Sexuality, AIDS and Society, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Jazmin Qquellon
- Center for Interdisciplinary Studies in Sexuality, AIDS and Society, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Silver K Vargas
- Center for Interdisciplinary Studies in Sexuality, AIDS and Society, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Michael Reyes-Diaz
- Center for Interdisciplinary Studies in Sexuality, AIDS and Society, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Kelika A Konda
- Center for Interdisciplinary Studies in Sexuality, AIDS and Society, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Carlos F Caceres
- Center for Interdisciplinary Studies in Sexuality, AIDS and Society, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Jeffrey D Klausner
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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Hamid TA, Elmekresh A, Parkar AZ, Al Masri MM, Saeedi Y. Male genital lesions in monkeypox virus infection: a case series. Can J Urol 2023; 30:11562-11567. [PMID: 37344469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
Monkeypox virus (MPV) is a rare zoonotic infection caused by an orthopoxvirus. The sudden outbreak of more than 3000 MPV infection from 50 countries has led the WHO to declare the infection as an "evolving threat of moderate public health concern". Here, we describe a case series of two cases of the MPV with a similar onset of cutaneous lesions in the genital area but with different progression in 35 and 41-year-old males respectively. Both of our patients were reported heterosexual with a 10-day prior history of unprotected sexual activity with a sex worker. Case 1 was uncomplicated having rashes over the chest, back, arms, and legs along with the occurrence of fluid-filled painless vesicles which was managed with topical antibiotic cream and wound care using povidone-iodine dressing along with oral amoxicillin/clavulanic acid. On the contrary, case 2 had a progressive necrotic lesion, which spread from the root of the penis involving the foreskin despite supportive measures eventually requiring circumferential surgical debridement of the foreskin. Hence, given the current outbreak, we must consider the possibility of genital MPV in patients with suggestive lesions, anywhere on the body (including the genitals), added to an epidemiological link or history of intimate contact with individuals that may be at high risk for transmission.
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Affiliation(s)
- Tariq Abdul Hamid
- Department of Urology, Dubai Hospital , Dubai Health Authority, Dubai, United Arab Emirates
| | - Amr Elmekresh
- Department of Urology, Dubai Hospital , Dubai Health Authority, Dubai, United Arab Emirates
| | | | - Mohamad Motaz Al Masri
- Department of Urology, Dubai Hospital , Dubai Health Authority, Dubai, United Arab Emirates
| | - Yaser Saeedi
- Department of Urology, Dubai Hospital , Dubai Health Authority, Dubai, United Arab Emirates
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Cozma EC, Celarel AM, Stoenica IV, Lupu M, Banciu LM, Voiculescu VM. Correlations between Histopathological and Confocal Reflectance Microscopy Aspects in a Patient with Bowenoid Papulosis. Diagnostics (Basel) 2023; 13:diagnostics13091531. [PMID: 37174923 PMCID: PMC10177300 DOI: 10.3390/diagnostics13091531] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/05/2023] [Accepted: 04/23/2023] [Indexed: 05/15/2023] Open
Abstract
Bowenoid papulosis is a cutaneous disease that is part of the spectrum of genital in situ carcinomas, caused primarily by infection with oncogenic strains of the HPV virus. The potential to transform into squamous cell carcinoma requires the diagnosis and treatment of the lesions. We present the case of a 34-year-old non-smoker without medical history who presented to our clinic for the appearance of multiple, asymptomatic, well-defined, flat, pigmented violaceous papules at the root of the penis in evolution for a year. Reflectance confocal microscopy (RCM) suggested the diagnosis of bowenoid papulosis, which was confirmed by histopathological examination. The treatment with Imiquimod 5% (3 times/week) and Isoprinosine (4 g/day) was initiated, followed by monitoring of the lesions by repeated RCM examination. The evolution of the patient at 6 weeks of therapy was favourable, with clinical remission of lesions and improvement in RCM aspects of the evaluated skin. In conclusion, RCM represents a useful noninvasive examination method that allows not only the diagnosis but also the follow-up of the treatment response in order to decide the appropriate length of therapy.
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Affiliation(s)
- Elena Codruta Cozma
- Department of Pathophysiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Dermatology and Allergology, Elias University Emergency Hospital, 011461 Bucharest, Romania
| | - Ana Maria Celarel
- Department of Dermatology and Allergology, Elias University Emergency Hospital, 011461 Bucharest, Romania
| | - Ioana-Valentina Stoenica
- Department of Dermatology and Allergology, Elias University Emergency Hospital, 011461 Bucharest, Romania
| | - Mihai Lupu
- Department of Dermatology, MEDAS Medical Center, 030447 Bucharest, Romania
| | - Laura Madalina Banciu
- Department of Dermatology and Allergology, Elias University Emergency Hospital, 011461 Bucharest, Romania
| | - Vlad Mihai Voiculescu
- Department of Dermatology and Allergology, Elias University Emergency Hospital, 011461 Bucharest, Romania
- Department of Dermatology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
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Barbara G, Albertini V, Tagi VM, Maggioni L, Gorio MC, Cattaneo C, Parazzini F, Ricci E, Buggio L, Kustermann A. Characteristics of Sexual Violence Against Adolescent Girls: A 10 Years' Retrospective Study of 731 Sexually Abused Adolescents. Int J Womens Health 2022; 14:311-321. [PMID: 35273451 PMCID: PMC8901429 DOI: 10.2147/ijwh.s343935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 02/04/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Sexual violence against young girls is a pervasive multifaceted phenomenon which embraces several different forced sexual acts, including attempted and/or completed rape, sexual coercion and harassment, and sexual contact with force or threat of force. The aim of this study is to evaluate the characteristics of sexual violence in adolescent girls, by a retrospective analysis of 731 consecutive cases of sexually abused girls. Materials and Methods We analyzed demographic characteristics, risk factors for rape, and the eventual subsequent presence and type of ano-genital lesions. Results We found that sexual violence with penetration was perpetrated in 591 (80%) cases. Vulnerability factors related with a major risk of rape were age >17 years old and consumption of alcohol and/or other drugs. About 196 (55%) victims had at a least one genital lesion. Conclusion A prompt identification of red flags of sexual violence may help physicians in suspecting and managing cases of sexual assault in adolescent girls, even in the absence of typical lesions.
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Affiliation(s)
- Giussy Barbara
- Gynecological Unit and SVSeD, Service for Sexual and Domestic Violence, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Valentina Albertini
- Department of Emergencies, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | | | - Lidia Maggioni
- Department of Biomedical Science, Legal Medicine Section, University of Milan, Milan, Italy
| | - Maria Carlotta Gorio
- Department of Clinical and Biomedical Sciences Luigi Sacco, University of Milan, Milan, Italy
| | - Cristina Cattaneo
- Department of Biomedical Science, Legal Medicine Section, University of Milan, Milan, Italy
| | - Fabio Parazzini
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Elena Ricci
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Laura Buggio
- Gynecological Unit and SVSeD, Service for Sexual and Domestic Violence, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessandra Kustermann
- Gynecological Unit and SVSeD, Service for Sexual and Domestic Violence, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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