An Unusual Case of Extra-Enteric Blastocystosis in the Uterine Cervix.

Extra-enteric infections by Blastocystis spp. have rarely been documented. Here, we report a case of extra-enteric blastocystosis in a patient with minimal cervicitis symptoms. A 47-year-old Hispanic female patient was attended in a primary health centre in Michoacan state, Mexico, for her routine gynaecological medical examination. As only symptom, she referred to a slight vaginal itching. The presence of several vacuolar-stages of Blastocystis spp. were identified by Papanicolaou staining; molecular identification was attempted by culture-PCR sequencing of a region of 18S gene from cervical and faecal samples obtained 2 months after cytological examination, even when patient declared that she tried self-medicating with vaginal ovules. Blastocystis ST1 was identified only in the faecal sample. The presence of Blastocystis spp. in the cervix of a patient with scarce symptomatology, demonstrates the extraordinary flexibility of this microorganism to adapt to new environments and niches.

Amoebic cervicitis mimicking posterior wall fibroid: a rare presentation.

Amoebiasis of the uterine cervix is an extremely rare entity, and presentation as fibroid uterus has not been reported, to the best of our knowledge in our extensive search of the English literature. It can clinically simulate cervical malignancy by virtue of surface papillomatous and overall ulcerated and necrotic appearance. We present a case of amoebic infection of the cervix in a 45-year-old female which was suspected to be a posterior wall fibroid with degeneration until a histopathological examination of the surgical specimen revealed the presence of Entamoeba histolytica trophozoites. The patient recovered after surgery and antiamoebic therapy.

Multiplex PCR testing detection of higher-than-expected rates of cervical mycoplasma, ureaplasma, and trichomonas and viral agent infections in sexually active australian women.

Knowing the prevalence of potential etiologic agents of nongonococcal and nonchlamydial cervicitis is important for improving the efficacy of empirical treatments for this commonly encountered condition. We describe four multiplex PCRs (mPCRs), designated VDL05, VDL06, VDL07, and VDL09, which facilitate the detection of a wide range of agents either known to be or putatively associated with cervicitis, including cytomegalovirus (CMV), enterovirus (EV), Epstein-Barr virus (EBV), varicella-zoster virus (VZV), herpes simplex virus type 1 (HSV-1), and herpes simplex virus type 2 (HSV-2) (VDL05); Ureaplasma parvum, Ureaplasma urealyticum, Mycoplasma genitalium, and Mycoplasma hominis (VDL06); Chlamydia trachomatis, Trichomonas vaginalis, Treponema pallidum, and group B streptococci (VDL07); and adenovirus species A to E (VDL09). The mPCRs were used to test 233 cervical swabs from 175 women attending a sexual-health clinic in Sydney, Australia, during 2006 and 2007. The agents detected alone or in combination in all cervical swabs (percentage of total swabs) included CMV (6.0), EV (2.1), EBV (2.6), VZV (4.7), HSV-1 (2.6), HSV-2 (0.8), HSV-2 and VZV (0.4), U. parvum (57.0), U. urealyticum (6.1), M. genitalium (1.3), M. hominis (13.7), C. trachomatis (0.4), T. vaginalis (3.4), and group B streptococci (0.4). Adenovirus species A to E and T. pallidum were not detected. These assays are adaptable for routine diagnostic laboratories and provide an opportunity to measure the true prevalence of microorganisms potentially associated with cervicitis and other genital infections.

Management of women with cervicitis.

In the past several years, the collective understanding of cervicitis has extended beyond the recognition of Chlamydia trachomatis and Neisseria gonorrhoeae as the prime etiologic suspects. Trichomonas vaginalis and herpes simplex virus cause cervicitis, and both Mycoplasma genitalium and bacterial vaginosis have emerged as new candidate etiologic agents or conditions. However, major gaps in our knowledge of this common condition remain. Putative etiologic agents have not been identified in many women with cervicitis. Moreover, cervicitis occurs in a relatively small proportion of women with chlamydia or gonorrhea. Finally, scant research has addressed the clinical response of nonchlamydial and nongonococcal cervicitis to antibiotic therapy, and there are no data on the benefit of sex partner treatment for such women. New research into the etiology, immunology, and natural history of this common condition is needed, especially in view of the well-established links between cervicitis and an increased risk of upper genital tract infection and human immunodeficiency virus type 1 acquisition.

[Uro-genital schistosomiasis with S. haematobium and infertility in Niger. Prospective study of 109 cases]. / Bilharziose uro-genitale a S. haematobium et infertilite au Niger. Etude prospective à propos de 109 consultantes.

Schistosomiasis represents the second most endemic diseases following malaria. It is now endemic in 76 countries of the world, and it is estimated that more than 200 million persons are infected. The objective of this work is to help in the improvement of knowledge about Female Genital Schistosomiasis (FSG) effects on the women reproductive. A transversal prospective survey during six months, on women consulting for infertility in the health reproductive center of Niamey. The women included (109 persons) have been asked and consulted in gynecology, cervical smears urine pathology, urine ragent strips test, vesico-renal and gynecologic trans-abdominal ultrasound, hysterosalpingography (HSG) and cervical biopsy on infected patients. The infestation prevalence at S.haematobium was 38,5%. The infected persons have presented more gyneco-obstétrical symptomatology than the non infested ones. The proportion of exocervicite was 31,0% by clinical examination. The cervical biopsy done on 26 bilharziosis patients confirmed the frequence of highs chronic exocervicites (50%) and leucoplasia (11,5%). Echography and HSG noticed that the bilharzios patients can let develop other annexiel pathologies such as: ovary cyst, peri-tuboovary adhesions and wide ovaries. The symptomatology felt by infested women showed the parasitose consequence on women in endemic area. The treatment in o large schaddle by the national program allows to reduce morbidity caused by that infection in Niger.

[The role of chlamydia trachomatis and some other associated microorganisms in endocervicitis].

The objective of the study was to examine the prevalence of Chlamydia trachomatis as a causative agent in women with clinically manifested endocervicitis and to find the age group where Chlamydia trachomatis was most prevalent. 553 women sexually active women in reproductive ag with clinically manifested endocervicitis e were examined. Chlamydial infection by direct immmunofluorescence was found in 239 (43, 2%) About 75% of the patients with chlamydial infection were in the age group 20-29 years. The predominant part of these women had no other associated infection except Chlamydia trachomatis. Association of Chlamydia trachomatis with candida albicans-25, 10%, bacteria vaginosis 23, 53%, Trichomonas vaginalis in 7.53% in the women with cervicitis.

[Paraendocervical route for metronidazole administration in complex treatment of chronic Trichomonas endocervicitis]. / Primenenie paraéndotservikal'nogo sposoba vvedeniia metronidazola v kompleksnom lechenii khronicheskogo trikhomonadnogo éndotservitsita.

The data on paraendocervical administration of metronidazole in the treatment of patients with relapsing Trichomonas endocervicitis are presented. Metronidazole was administered as 0.5% solution in a dose of 0.04 g once a day for 8-10 days in complex traditional therapy including oral use of metronidazole and immunocorrigating and local treatment. It was shown that paraendocervical administration of the protistocidal agent provided earlier regression of the urogenital symptoms and 2.8 times lower frequency of the relapses.

The enigmatic cervix.

Because of the serious complications associated with cervicitis, detection of the clinical signs of cervicitis is paramount importance to the reproductive health of young women. This article discusses causes of infectious and noninfectious cervicitis, as well as, the interactions of cervicitis with well-known diseases.

Schistosomiasis and cervical cancer in Ghana.

OBJECTIVE: To discover a possible association between schistosomiasis and cervical dysplasia and/or cervical cancer in Ghana, West Africa. METHOD: Two groups of 24 subjects each were identified, one group from a schistosomiasis-endemic area and a control group from a non-endemic area. Random cervical biopsies, cervical cytology and human papilloma virus (HPV) DNA testing were performed on all subjects. Demographic data were analyzed using Student's t-test. Histologic and DNA findings were analyzed using Fisher's exact test. RESULTS: From the endemic area, 46% of subjects had histologic evidence of schistosomiasis infection of the cervix. No evidence of dysplasia or cancer on cervical cytology was noted in this group. Mild dysplasia was noted in random cervix biopsies in one patient, and 8 patients had evidence of HPV infection of the cervix. No patient from the non-endemic area had cytologic or histologic evidence of cervical dysplasia or cancer. Eleven subjects in this group had evidence of HPV infection. CONCLUSION: This study does not reveal an association between cervical schistosomiasis and cervical dysplasia or cervical cancer on cytology or histology. Both study groups demonstrated a high degree of infection with HPV, however. It may be the HPV and not the schistosomiasis which is responsible for the development of uterine cervix cancer.

[Frequency of vaginal trichomoniasis and candidiasis and its relation to the clinical profile]. / Frecuencia de tricomoniasis y candidiasis vaginal y su relación con el cuadro clínico.

Eight hundred samples of vaginal swabs were taken from women with active sexual life attending the Cervicouterine Cancer Opportune Detection Service at the Familial Medicine Unit No. 18 of the National Institute of Social Security, to study the incidence and prevalence of vaginal trichomoniasis, the presence of yeasts of the genus Candida and their relationships with clinical features of vulvovaginitis. Identification of parasites was made by means of direct examination with light microscope; 14.39 per cent of candida vulvovaginitis against 3.13 per cent of trichomoniasis was found; in only five cases the two parasites were associated. Leukorrhea and vaginal pruritus were the major symptoms found and the most affected anatomical regions were vaginal walls in trichomoniasis and cervix in candidiasis. Although vaginal trichomoniasis is a worldwide distributed parasitosis, its frequency is very variable, not so vaginal candidiasis, which is more frequent.

Squamous cell carcinoma associated with amoebic cervicitis. Report of a case.

A case of squamous cell carcinoma associated with amebiasis is presented. Protozoa identified as Entamoeba histolytica were found in a routine Papanicolaou smear and in the cervical biopsy of a young woman following the initial diagnosis of cervical cancer and the institution of a radiation therapy regimen. No amoebae were found in repeated stool specimens. The late detection and diagnosis of amebiasis precluded any possible changes in the management of the case. Initial follow-up for the carcinoma demonstrated that the patient was not responding well to therapy; her failure to return to the clinic precluded long-term follow-up and treatment for the amebiasis.

Subepithelial organisms in trichomonal cervicitis.

Trichomonas vaginalis is usually described as a surface-dwelling, noninvasive organism. Most studies of the pathogenicity of this organism have been derived from cytologic studies of uterine cervical epithelium. We employed specific immunoperoxidase techniques that allow the identification of organisms in cytologic and histologic specimens. In a case of trichomonal cervicitis these organisms were demonstrated both on the epithelial surface and in subepithelial tissues. Interpretations and implications of these findings are discussed.

[Prevention and epidemiology of trichomonal vaginitis in women treated in gynecological departments]. / Profilaktyka i epidemiologia rzesistkowicy pochwy kobiet leczonych w oddzialach ginekologicznych.

The purpose of the work is to present the results of prophylactic actions used in the Departments of the Institute of Obstetrics and Gynecology of the Medical Academy in Bia l ystok giving reasons for changes and modifications concerning the present state of procedures. At the same time, attention has been paid to some epidemiological factors of trichomoniasis in women treated in gynecological departments for various diseases of the female genital organ. Women treated in the Departments of the Institute of Obstetrics and Gynecology in 1974-1975 were included in these studies. Total number of the investigated women was 9000 but those with trichomoniasis were 610. There were presented the results of procedures at the admittance rooms of the Gynecological Departments in which examinations and treatment of trichomoniasis, in reasonable cases, were carried out before admitting the patients to proper gynecological treatment were presented. The whole of the evaluation was based on our own scheme of microbiological procedures.

Gnathostoma spinigerum from the cervix of a woman in Jakarta.

A male Gnathostoma spinigerum was removed from the cervix of a 29-year-old Jakarta resident who suffered from chronic cervicitis. The worm was 6.7 mm in length and had eight rows of spines on the cephalic bulb. This is the third case of gnathostomiasis reported from Indonesia.