Daniel C. William

High rates of enteric protozoal infections in selected homosexual men attending a venereal disease clinic.

Stool specimens from 89 high-risk, sexually active homosexual men were screened for enteric protozoal cysts. Patients whose specimens contained nonpathogenic cysts were investigated further by examination of fresh purged specimens. A total of 27 of the initial specimens (30%) contained protozoal cysts. Twenty-three patients (26%) harbored pathogens. There were 18 cases (20%) of amebiasis and 11 cases (12%) of giardiasis. Six men (7%) had concurrent amebiasis and giardiasis. The presence of infections correlated with a history of anilingus but not with place of birth, travel, or history of symptoms. The exceptionally high rate of prevalence of intestinal protozoal infection in this population suggests that enteric protozoal infections arc important among sexually transmitted diseases.

The utility of anoscopy in the rapid diagnosis of symptomatic anorectal gonorrhea in men.

Thirty-nine homosexual men seeking treatment for symptomatic proctitis were examined for anorectal gonorrhea by study of gram-stained smears obtained via an anoscope and by a blindly obtained anorectal swab specimen. Anorectal specimens for culture were obtained from all men. The sensitivity of the anoscopically obtained smears was 79% as compared with 53% for the blindly obtained smears. It was concluded that gram-stained smears obtained through an anoscope can provide rapid diagnosis of most cases of symptomatic anorectal gonorrhea. All patients with symptomatic proctitis should have routine anoscopy and examination of gram-stained smears obtained via anoscopy as part of their diagnostic evaluation.

Neisseria meningitidis. Probable pathogen in two related cases of urethritis, epididymitis, and acute pelvic inflammatory disease.

THE ISOLATION of Neisseria meningitidis from the genitourinary tract and anal canal of persons tested for gonorrhea has been noted with increasing frequency. While urethritis, epididymitis, and pelvic inflammatory disease are usually associated with the gonococcus, two epidemiologically linked cases of these local complications occurred in sexual partners in whom N meningitidis of the indicated 29E serotype was isolated. Report of Cases Case 1.— A 19-year-old man came to the Ft Greene Social Hygiene Clinic complaining of a four-week history of an intermittent, scant, mucoid urethral discharge. There was no history of dysuria. Four weeks previously he had come to the same clinic with similar complaints. At this initial visit, findings of his physical examination were normal. A urethral smear showed no polymorphonuclear leukocytes, and a culture for gonorrhea and a VDRL test for syphilis were both negative. On the subsequent visit four weeks later, a scant urethral discharge was

Gonococcal Infections in Children 14 Years and Younger Epidemiologic and Other Lessons Drawn from a Survey of 30 Instances

GONOCOCCAL infections in infants and children have paralleled the rising incidence seen in adults. From 1956 to 1974, the incidence rate has tripled.’ Neonatal gonococcal infections are most commonly acquired during passage through the infected maternal birth canal.~ In infants, gonococcal infections may be acquired through nonsexual contact with infected family members or fomites.~ Although nonvenereal transmission may occur in young children and preadolescents, precocious sexual activity has been implicated as the

Pharyngeal carriage of Neisseria meningitidis and anogenital gonorrhea: evidence for their relationship.

The relationship between pharyngeal carriage of Neisseria meningitidis and anogenital infection with Neisseria gonorrhoeae was investigated at two separate clinics for sexually transmitted diseases in New York City. Of the entire study group of 738 patients, 310 (42%) had pharyngeal N. meningitidis. Gonorrhea appeared in 130 (17.9%) of the 738 patients. Of the 130 patients with anogenital gonorrhea, 73 (56.3%) had N. meningitidis-positive pharyngeal cultures. Neisseria meningitidis was found in the pharyngeal cultures of 39% of the gonorrhea-free patients; 23.2% of patients with N. meningitidis-positive pharyngeal cultures had concomitant anogenital gonorrhea. Of the patients free of pharyngeal N. meningitidis, 13.1% had anogenital gonorrhea. In both facilities, the pharyngeal carriers of N. meningitidis had a 1.9 times greater risk of genital gonorrhea as compared with N. meningitidis-negative patients. Patients with anogenital gonorrhea at both study sites were 1.4-1.7 times more likely to be pharyngeal carriers of N. meningitidis as compared with gonorrhea-free patients.

Spectinomycin in the treatment of anal gonorrhea: a retrospective study.

The authors conducted a retrospective study of 125 male patients treated for anal gonorrhea with 4 g of spectinomycin in a social hygiene clinic. Of those treated, nine (7.2%) still had cultures positive for Neisseria gonorrhoeae when tested again five to 14 days after treatment.

Comparison of ampicillin plus probenecid with amoxicillin plus probenecid for treatment of uncomplicated gonorrhea.

The efficacy of 3 g of amoxicillin plus 1 g of probenecid was compared with the efficacy of 3.5 g of ampicillin plus 1 g of probenecid for the treatment of uncomplicated gonorrhea. In a clinical trial no therapeutic failure was seen among 60 patients who were treated with the former regimen. The combination of ampicillin plus probenecid resulted in two therapeutic failures (3.6%) among the 55 patients given it. It was concluded that amoxicillin plus probenecid is as effective as ampicillin plus probenecid for the treatment of uncomplicated gonorrhea.