Ticks on the external male genital structures.

Penis and scrotum are very rarely affected by tick bites. We present four cases of involvement of male genitals by ticks belonging to the family Ixodidae. Dermatological examination showed an apparently healthy skin around the tick. Anti-Borrelia burgdorferi antibodies were negative. In all patients the entire body of the tick was delicately removed by means of pliers. Antibiotic therapy was unnecessary.

Isolated Superficial Dorsal Penile Vein Thrombosis due to Scabies Infestation.

Thrombosis or thrombophlebitis of the superficial dorsal vein of the penis is called penile Mondor's disease. Although many factors are suggested as the etiology, but it has not been clarified yet. Hypersensitivity reactions may predispose to this complication in some patients; and it results from the formation of antigen-antibody immune complexes in the circulation as a consequence of the penetration of antigenic debris into the circulation due to pruritus-related excoriations caused by parasitic infestations like scabies. Herein, we present a case of isolated superficial dorsal penile vein thrombosis developing due to scabies infestation without any additional thrombogenic factors. Conservative approach and medical treatment were sufficient in the successful treatment of scabietic penile Mondor's disease.

Performance of self-collected penile-meatal swabs compared to clinician-collected urethral swabs for the detection of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and Mycoplasma genitalium by nucleic acid amplification assays.

Men were enrolled in a study to assess the performance and acceptability of self-collected penile meatal swabs as compared to clinician-collected urethral swabs for sexually transmitted infections (STIs). We expected penile-meatal swabs to perform favorably to urethral swabs for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV), and Mycoplasma genitalium (MG) detection by nucleic acid amplification assays (NAATs). Of 203 swab pairs tested; for CT, penile-meatal swab sensitivity was 96.8% and specificity was 98.8%. NG sensitivity and specificity were 100% and 98.9%, respectively. For TV, sensitivity was 85.0% and specificity was 96.7%. For MG sensitivity and specificity were 79.3% and 99.4%, respectively. No significant statistical differences between sample type accuracy (CT: P=0.625; NG: P=0.248; TV: P=0.344; and MG: P=0.070) existed. Most men, 90.1%, reported self-collection of penile-meatal swabs as "Very Easy" or "Easy". Self-collected penile-meatal swabs appeared acceptable for NAAT STI detection and an acceptable collection method by men.

Characterization of an outbreak of emerging bovine besnoitiosis in southwestern Spain.

Bovine besnoitiosis is an emerging disease in Europe, presenting quick spread toward central and southern Spain. Characterization of an outbreak in a free-ranging Limousin and Avileña beef cattle herd from southwestern Spain territories is attempted. Serological survey in the herd revealed increase of number of infected animals, from 34.3 % on first diagnoses/exams on December 2013 to 42.5 % in the second on April 2014. Blood analysis and serum biochemistry showed important alterations like leukocytosis (+33.2 % of mean value), with lymphocytosis (+205.3 %) and increase of LDH (+25.1 %), associated with tissue damage. Clinical cases were only observed in Limousin animals. Along with typical lesions of acute and chronic besnoitiosis, inflammatory and degenerative processes and parasitic cysts were present in the corpus cavernosum and the corpus spongiosum of penis. By using polymerase chain reaction (PCR) sequencing of 18S rDNA, Besnoitia besnoiti was confirmed as causative agent; microsatellite sequence analyses showed the homology of isolates with previously studied strains.

Variation in the saccharide lectin binding pattern from different isolates of Tritrichomonas foetus.

Tritrichomonas foetus (T. foetus) is the causal agent of bovine tritrichomonosis (BT), a venereal disease that causes significant economic losses in the bovine livestock industry. The structural organization of T. foetus presents a cell membrane, an undulating membrane which extends along the parasite, three anterior flagella and a recurrent posterior flagellum. The interaction between the superficial glycoconjugates of the parasite and the host cell is one of the most relevant pathogenic mechanisms. In the present study, we analyzed the saccharide pattern through lectincytochemistry of the cell membrane, undulating membrane, cytoplasm and flagella of 28 isolates of T. foetus. Lectins that labeled most of the isolates were WGA, Con-A, RCA-I, LCA, GS-II and PHA-E showing the presence of D-mannose, D-glucose, N-acetylglucosamine and sialic acid. On the other hand, no labeling was observed in any of the structures with VVA, STA, LEA, Jacalin, GS-I, SJA, PHA-L, DSA, and weak labeling was observed with DBA, PNA, SBA and UEA I, showing therefore a low expression of N-acetylgalactosamine, L-fucose and galactose. In addition, GS II labeled in a granular pattern when lectincytochemistry was positive, whereas LCA strongly labeled the membranes and weakly the cytoplasms. The labeling variations observed among the isolates analyzed in the present work, could be related to differences in the pathogenic behavior of the isolates.

Detection of Leishmania infantum in the smegma of infected dogs / Detecção de Leishmania infantum no esmegma de cães infectados

Considering the venereal transmission of visceral leishmaniasis from dogs to bitches, the aim of this study was to verify if the penile surface and smegma from infected dogs can be the source of parasites in bitches. Twelve Leishmania infantum infected dogs had semen and smegma samples collected for submission to PCR identification of the DNA of the parasite. Semen (41.7 percent) and smegma (50.0 percent) have similar positive incidence (P>0.05; Fisher's exact test), with 58.3 percent of the dogs positive for semen and/or smegma samples. The proportion of positivity for both semen and smegma was 33.3 percent, but 8.3 percent was positive only for semen, and 16.7 percent only for smegma, revealing a moderate agreement between tests (K=0.5; Kappa index). It was concluded that Leishmania infantum is present in the smegma of contaminated dogs and it can be a source of parasites for the semen and the bitch...

Tendo em vista a transmissão venérea da leishmaniose visceral do cão para a cadela, o objetivo deste estudo foi verificar se a superfície peniana e o esmegma de cães infectados poderiam ser a fonte de parasitas para a fêmea. Amostras de sêmen e esmegma de 12 cães infectados com Leishmania infantum foram submetidas à identificação do DNA do parasita por PCR. As incidências de positividade no sêmen (41,7 por cento) e no esmegma (50,0 por cento) foram semelhantes (P>0,05; teste exato de Fisher), sendo 58,3 por cento dos cães positivos para sêmen e/ou esmegma. A positividade para sêmen e esmegma juntos ocorreu em 33,3 por cento, mas em 8,3 por cento dos casos apenas no sêmen, e em 16,7 por cento apenas no esmegma, o que revela uma concordância moderada entre os testes (K=0,5; índice Kappa). Conclui-se que a Leishmania infantum está presente no esmegma de cães contaminados, podendo ser a fonte de parasitas para o sêmen e a cadela...

Tritrichomonas foetus: prevalence study in naturally mating bulls in Switzerland.

Switzerland is officially free from bovine Tritrichomonas foetus. While bulls used for artificial insemination (AI) are routinely examined for this pathogen, bulls engaged in natural mating, as well as aborted fetuses, are only very sporadically investigated, indicating that the disease awareness for bovine tritrichomoniasis is low. Natural mating in cattle is becoming increasingly popular in Switzerland. Accordingly, a re-introduction/re-occurrence of T. foetus in cattle seems possible either via resurgence from a yet unknown bovine reservoir, or via importation of infected cattle. The low disease awareness for bovine tritrichomoniasis might favor an unnoticed re-establishment of T. foetus in the Swiss cattle population. The aim of our study was thus to search for the parasite, and if found, to assess the prevalence of bovine T. foetus in Switzerland. We included (1) bulls over two years of age used in natural mating and sent to slaughter, (2) bulls used for natural service in herds with or without fertility problems and (3) aborted fetuses. Furthermore, the routinely examined bulls used for AI (4) were included in this study. In total, 1362 preputial samples from bulls and 60 abomasal fluid samples of aborted fetuses were analyzed for the presence of T. foetus by both in vitro cultivation and molecular analyses. The parasite could not be detected in any of the samples, indicating that the maximal prevalence possibly missed was about 0.3% (95% confidence). Interestingly, in preputial samples of three bulls of category 1, apathogenic Tetratrichomonas sp. was identified, documenting a proof-of-principle for the methodology used in this study.

A case of giant hyperkeratotic cutaneous leishmaniasis in the penis.

Cutaneous leishmaniasis is a protozoan disease caused by leishmanias, which results in deformations of the skin. Cutaneous leishmaniasis is endemic in the southeastern parts of Turkey. Cutaneous leishmaniasis is the most common form and is often observed in open regions of the body. Involvement of the penis was rarely reported. In this paper, we present a case of a giant hyperkeratotic form of cutaneous leishmaniasis in the glans penis.

Trichomonas vaginalis infection in men who submit self-collected penile swabs after internet recruitment.

BACKGROUND: Submission of self-collected penile samples collected at home could remove barriers that men face in getting tested for sexually transmitted infections (STIs). METHODS: From December 2006 to July 2012, sexually active men aged ≥14 years were recruited by an educational internet program (http://www.iwantthekit.org) which offered free testing for Trichomonas vaginalis infection. Kits were ordered online and swabs were sent via US mail to the laboratory and tested by nucleic acid amplification tests. Demographics and sexual risk factors were accessed by questionnaires. Men called or were contacted to receive their results. Risk factors for trichomonas infection were determined by multivariate logistic regression RESULTS: Of 4398 men requesting kits, 1699 (38.6%) returned swabs by mail (55.4% returned in 2012). Forty-one percent of men were aged <25 years, 43% were black subjects and 45% were white. The overall prevalence for trichomonas in the 1699 men was 3.7%; the highest prevalence by age group was for men aged 40-49 years (5.2%) and, by year, 216 men screened in 2008 had the highest prevalence (12.5%). Risk factors for 919 men whose risk information was collected by questionnaire (prevalence 6.0%) indicated that 9.6% had a concurrent chlamydia infection. Significantly associated risks factors included: black race (adjusted OR 2.67), residence in Illinois (OR 12.02), age 30-39 years (OR 6.63) and age >40 years (OR 5.31). CONCLUSIONS: A fairly high prevalence of trichomonas and sexual risk factors were demonstrated from internet recruitment of men. This method of engaging men to get screened for trichomonas may augment screening in STI clinics.

Comparison of self-obtained penile-meatal swabs to urine for the detection of C. trachomatis, N. gonorrhoeae and T. vaginalis.

BACKGROUND: Self-obtained penile-meatal swabs and urine specimens have been used for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) for outreach screening in men. OBJECTIVE: To compare the sensitivity of self-collected male penile-meatal swabs and urine for the detection of CT, NG and TV. METHODS: Matching penile-meatal swabs and urines were collected at home after recruitment to the study; via the internet programme, http://www.iwantthekit.org. The instructions directed the participant to place the tip of a Copan flocked swab at the meatal opening of the urethra to collect the penile-meatal sample. Two ml of urine was collected after the swab onto a Copan sponge-on-a-shaft collection device. Both swab and urine were placed into individual Aptima transport media tubes and mailed to the laboratory for testing. All specimens were tested for CT and NG using the GenProbe Aptima Combo2 Assay and for TV using GenProbe Aptima Analyte Specific Reagents with TV oligonucleotides. RESULTS: Of 634 men, 86 (13.6%) were positive for CT, 9 (1.4%) were positive for NG and 56 (9.3%) positive for TV. For CT, swab sensitivity was 81/86 (94.2%), and urine sensitivity was 66/86 (76.7%). For NG, swab sensitivity was 9/9 (100%) and urine sensitivity was 8/9 (88.9%). For TV, swab sensitivity was 45/56 (80.4%) and urine sensitivity was 22/56 (39.3%). CONCLUSIONS: Self-obtained penile-meatal swabs provided for the detection of more CT, NG and TV, than urine specimens.

Rhinosporidiosis affecting multiple parts of the body.

Rhinosporidiosis is a rare chronic granulomatous condition caused by a fungus (Rhinosporidium seeberi). It has been seen mainly in southern India, Sri Lanka and Pakistan. This is the first published report of a patient with multiple rhinosporidiosis. He had lesions in the nares, in multiple areas of the skin, in the external urethral meatus, glans of penis and the perineum.

Genital myiasis by Wohlfahrtia magnifica (Diptera, Sarcophagidae) in Sicily (Italy).

Wohlfahrtia magnifica (Schiner, 1862; Diptera: Sarcophagidae), known also as flesh fly or screwworm, is a fly distributed especially in south Europe, Middle East, North Africa and China. Maggots of W. magnifica are responsible for traumatic myiasis in warm-blooded vertebrate animals and humans. In Italy data on wohlfahrtiosis in animals and humans are scant. This paper reports three cases of genital myiasis by W. magnifica in Sicily that occurred in a goat, a ram and a dog, respectively. Maggots were found in the vulva of a goat, in a wound localised in the scrotum of a ram and in the prepuce of a dog. Although the disease was not recorded before in the region, data collected from a questionnaire specifically designed for the study suggest that the disease is endemic in the area for more than 20 years. Larger epidemiological studies in the region are needed to get more data on disease prevalence and pattern of infestation as well as more information and education is needed for both farmers and veterinarians on wohlfahrtiosis and its strategies of control and treatment.

[The influence of the degree of infestation with trematode parthenites on the structure of penial glands in the mollusks Littorina saxatilis of different age].

Histological and confocal microscopy studies of the structure of penial glands in the Littorina saxatilis males were carried out. The examined mollusks belong to two age groups and were at different stages of spontaneous infection with a trematode from the pygmaeus species group (Microphallus piriformes). Based on comparative analysis of microscopic sections of copulative organs in infested and non-infested mollusks, data on the modifications in histological structure ofpenial glands were obtained. From these data we can suggest that the infestation have an influence on all parts of the gland. Decrease of secret production and reduction of muscular capsule (down to its disappearance) were observed. We suppose that changes in the penial glands structure prevent their normal functioning. In the mollusks infested on reaching the sexual maturity, gradual reduction of distal part of reproductive system was observed, while in the mollusks infested before the sexual maturity, development of ancillary part of reproductive system was blocked.

Parasitic castration of Buccinanops cochlidium (Gastropoda: Nassariidae) caused by a lepocreadiid digenean in San José Gulf, Argentina.

Parasitic castration of Buccinanops cochlidium from San José Gulf, Argentina, caused by a lepocreadiid digenean, is reported for the first time. Rediae and ophtalmotrichocercous cercariae probably belonging to Opechona sp. were identified in the gonad and digestive gland. Opechona sp. has been reported previously parasitizing B. monilifer from a northern locality in the Argentine Sea. Overall prevalence of infection was 15.5%; it varied seasonally, rising during the warm months after the host oviposition period. Cercariae were expelled at the same time as the hatching of snail embryos (during the higher water temperature period). Rediae affected male and female snails equally, but prevalence increases along with host size. The parasite causes the complete castration of the host. Parasitized adult snails showed a reduction of penis size in comparison with healthy males. It remains to be confirmed whether the peak of cercariae emission coincides with the presence of jellyfishes and scombrid or other fishes in the area, which could act as second intermediate and definitive hosts, respectively.

Giant penoscrotal filariasis.

A 42 year old male individual having a hugely distended scrotum and barely perceptible penis, unable to maintain his livelihood on account of his handicap and socially withdrawn for the fear of humiliation, got admitted into the Surgery department of Mymensingh Medical College Hospital in August 5, 2007. The person had been carrying the so called curse for the last four years. On the basis of clinical, serological and haematological examinations, diagnosis was established as lymphatic filariasis causing elephantiasis of the scrotum. After assessment for operative feasibility, the patient underwent an operation in August 20, 2007 during which, ligation of both the spermatic cords, excision of the scrotum along with the testicles and reposition of the penile shaft into the anterior pelvic wall in the subcutaneous plane (Fleying procedure) was performed. The scrotum measured about 36 inches in diameter and weighed 40 kgs after excision. Histopathological examination of the scrotal skin confirmed the diagnosis. The patient was released without any complication, on the 11th post operative day after removal of stitches, with indwelling urethral catheter. He was prescribed Doxicycline for the next 8 weeks, a drug which has been found to be effective in treating filariasis in a number of studies, and acts by killing a symbiotic bacteria necessary for the survival of the worm. Follow up after 3 months was uneventful.

Urgent penectomy in a patient presenting with epidermoid carcinoma of the penis associated to myiasis.

The objective of this study is to describe the case of a patient presenting advanced epidermoid carcinoma of the penis associated to myiasis. A 41-year-old patient presenting with a necrotic lesion of the distal third of the penis infested with myiasis was attended in the emergency room of our hospital and was submitted to an urgent penectomy. This is the first case of penile cancer associated to myiasis described in the literature. This case reinforces the need for educative campaigns to reduce the incidence of this disease in developing countries.