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1/11. streptococcus viridans intra-amniotic infection associated with antecedent cunnilingus.

    Introduction of bacteria into the amniotic cavity has been associated with oral sex through an ascending infectious route. Previous reports have implicated both capnocytophaga and fusobacterium nucleatum via this process. We report a case of streptococcus viridans intra-amniotic infection occurring at 25 weeks' gestation. Patient questioning revealed a close temporal relationship between the onset of symptoms and previous episodes of cunnilingus. The diagnosis of subclinical bacterial colonization of the amniotic fluid should be considered in patients presenting with preterm labour and no apparent aetiology. A history of recent cunnilingus may be associated with the presence of streptococcus viridans in the amniotic fluid. ( info)

2/11. Sexually transmitted q fever.

    We report the sexual transmission of coxiella burnetii from a man with occupationally acquired q fever to his wife. Fifteen days after coitus, his wife also developed serologically proven acute q fever. C. burnetii dna sequences were detected by polymerase chain reaction (PCR) performed on semen samples obtained from the husband at 4 and 15 months after the onset of acute q fever, but PCR results were variable at 23 months, indicating the presence of few organisms. ( info)

3/11. Dermatological symptoms and sexual abuse: a review and case reports.

    Dermatological symptoms in cases of sexual abuse can be very diverse. To establish a causal relationship between skin diseases and sexual abuse is particularly difficult. In dermatology, three main areas of presentation can be identified. ACUTE CONSEQUENCES: Direct injuries found on the genitalia and body. Behaviour and psychological changes seen. sexually transmitted diseases (STD) may be identified, after an appropriate incubation period. LONG-TERM CONSEQUENCES: In the long term, even decades later, patients may manifest with a wide spectrum of psychosomatic manifestations of skin diseases, particularly factitious disorders. IMITATIONS: A group whose skin manifestations may mimic and be mistaken for sexual abuse. The initial suspicion of sexual abuse and the need for specific questioning and investigations can lead to a disturbance in the doctor-patient relationship. ( info)

4/11. Cutaneous tuberculosis of the penis and sexual transmission of tuberculosis confirmed by molecular typing.

    A case of culture-positive primary cutaneous mycobacterium tuberculosis infection of the penis was diagnosed in a male patient; 1 year later, endometrial tuberculosis was diagnosed in the patient's wife. These organisms were confirmed to be indistinguishable by use of molecular techniques. ( info)

5/11. shigella sonnei: another cause of sexually acquired reactive arthritis.

    We report a case of reactive arthritis attributable to sexually-acquired shigella sonnei infection. This occurred in the context of an outbreak of S. sonnei among homosexually-active men in Sydney, australia, in 2000. ( info)

6/11. Invasive group a streptococcus associated with an intrauterine device and oral sex.

    BACKGROUND: peritonitis due to group A streptococcus (GAS) and toxic shock syndrome occurred in a previously healthy 45-year-old woman with an intrauterine device. The intrauterine device was believed to be the portal of entry. In addition, her husband was found to be an asymptomatic carrier of GAS in his oropharynx. GOAL: The goal was to increase physicians' awareness of oral sex as a risk factor for transmission of invasive GAS disease. STUDY DESIGN: This is a case report of the development of GAS peritonitis and toxic shock syndrome in a woman after acquisition of the organism through oral sex. RESULTS: The GAS strains isolated from the patient and her husband were identical in their M-type, T-type, and exotoxin gene pattern. CONCLUSION: Because the couple practices oral sex, it was postulated that this was the mode of transmission of the GAS. ( info)

7/11. Concurrent fecal colonization with extraintestinal pathogenic escherichia coli in a homosexual man with recurrent urinary tract infection and in his male sex partner.

    A 72-year-old homosexual man experienced frequent recurrences of symptomatic urinary tract infection (UTI) putatively due to the same strain of extraintestinal pathogenic escherichia coli, despite receiving repeated courses of seemingly appropriate antibiotic therapy. Both the patient and his male sex partner were found to have fecal colonization with the strain recovered from the patient's urine, which exhibited characteristics of the E. coli O1/O2:K1:H7 clonal group (which is associated with urosepsis), whereas genetically distinct E. coli strains were recovered from a jar of petroleum jelly used by the couple during sexual activity. ( info)

8/11. Acute urethritis caused by neisseria meningitidis.

    A 48-year-old heterosexual Japanese man visited the outpatient clinic of Nagoya urology Hospital, complaining of burning pain at voiding and pus discharge from the urethral orifice. These symptoms appeared the day following oral-genital contact (fellatio) with a commercial sex worker. On the basis of the presumptive clinical diagnosis of gonorrhea because of the microscopic detection of diplococci in the urethral discharge, he was treated with levofloxacin (300 mg per day) for 7 days. His symptoms responded quickly and urinalysis taken 7 days later was normal. Microbiological examinations isolated neisseria meningitidis in the urethral discharge by culture with the use of enzymatic profiles. Further prevalence of sexually transmitted diseases (STD) through oral-genital contact would lead to an increase in meningococcal urethritis. ( info)

9/11. Person-to-person transmission of brucella melitensis.

    Human brucellosis is primarily an occupational hazard in the USA; in the middle east and africa ingestion of contaminated dairy products is an important route of infection. Whether human beings can become infected via person-to-person spread is uncertain. During an investigation of a commonsource, laboratory-associated outbreak due to brucella melitensis, biotype 3, the wife of a microbiologist with serologically proven brucellosis became infected. Her blood isolate was indistinguishable from the epidemic strain. In the absence of other risk factors, we suggest that sexual intercourse is a possible means of transmission. ( info)

10/11. Heterosexual transmission of community-associated methicillin-resistant staphylococcus aureus.

    Heterosexual transmission of community-associated methicillin-resistant staphylococcus aureus has not been documented. As part of a survey conducted in northern Manhattan, we encountered 3 households in which heterosexual transmission was responsible for new community-associated methicillin-resistant S. aureus infection. The vaginal and inguinal isolates obtained from the sexual partners were USA 300. This report documents an important and previously unrecognized means of community-associated methicillin-resistant S. aureus colonization and transmission for these potentially invasive strains. ( info)
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