Ricardo Casco

Lichenoid secondary syphilis

Argentina Case 1 A married, heterosexual, promiscuous, 29‐year‐old white man had experienced an asymptomatic eruption on the trunk and left palm for the last 3 months. After 2 months, the trunk involvement disappeared, but 2 weeks later lip and tongue lesions developed. No history of genital ulcer was found.

Molecular typing of Treponema pallidum isolates from Buenos Aires, Argentina: Frequent Nichols-like isolates and low levels of macrolide resistance

A total of 54 clinical samples, including genital lesion swabs, whole blood and cerebrospinal fluid from patients diagnosed with syphilis were collected in 2006 and in 2013 in Buenos Aires, Argentina. Treponemal DNA was detected in 43 of the analyzed samples (79.6%) and further analyzed using Sequencing-based molecular typing (SBMT) and Enhanced CDC-typing (ECDCT). By SBMT, 10 different Treponema pallidum subsp. pallidum (TPA) genotypes were found, of which six were related to the TPA SS14 strain, and four to the TPA Nichols strain. The 23S rRNA gene was amplified in samples isolated from 42 patients, and in six of them (14.3%), either the A2058G (four patients, 9.5%) or the A2059G (two patients, 4.8%) mutations were found. In addition to Taiwan, Madagascar and Peru, Argentina is another country where the prevalence of Nichols-like isolates (26.8%) is greater than 10%.

Lymphogranuloma venereum: tertiary stage

From the Division of Dermatology, University Hospital, University of Buenos Aires Medical School; and the Sanatorio Otamendi, Buenos Aires, Argentina A 64-year-old, heterosexual white man presented with a 3-year history of lymphedema of the scrotum and penis, purulent discharge from fistulas, and abscess of the perineal and perianal area. The patient had an indolent progression of the disease without systemic manifestations. Twelve years before, the right testis had been totally excised because of an abscess of unknown etiology. Histopathologic examination revealed a chronic nonspecific inflammatory orchitis with abscess formation. The patient and his wife denied a history of sexually transmitted diseases.

Evolution of Neisseria gonorrhoeae drug susceptibility in Buenos Aires, Argentina, 1985–99

Buenos Aires (Argentina) is an international port city of three million people surrounded by greater Buenos Aires, with a core population of 10 million people. The STD service of the Hospital Nacional de Cllinicas, University of Buenos Aires (HNC) deals with 80% patients from the city and 20% from the suburban areas. A total of 33 316 symptomatic patients (27 458 men and 5858 women) were studied from 1985–99.1 Patients attended under the standard regulations of HNC primary care protocol, and so no additional written informed consent was required. Neisseria gonorrhoeae (NG) was investigated by direct Gram stain microscopy and by culture in Columbia agar supplemented with 5% blood and …

Evaluation of the utility of a rapid test for syphilis at a sexually transmitted disease clinic in Buenos Aires, Argentina

Even though syphilis can be easily diagnosed by simple and low-cost laboratory methods, it continues to be an important health problem. Rapid tests (RT) for the detection of treponemal antibodies can facilitate earlier diagnosis, access to treatment and linkage to care. The aim of this study was to analyse the usefulness of the incorporation of a RT in the detection of patients infected with T. pallidum in a sexually-transmitted disease (STD) clinic. Between March and December 2015, a syphilis RT was offered to patients who spontaneously attended the clinic. Conventional serology testing was additionally indicated to every participant. The RT for syphilis was offered to 1887 patients, of whom 31.1% agreed to get tested. VDRL test was performed in 84.0% of patients that were also tested with syphilis RT, with a significantly higher frequency observed among participants with reactive RT (94.3% vs. 79.8%, p < 0.001). These results showed that 33.7% of the participants were reactive for the RT and 27.0% were reactive for the VDRL test. Both tests were reactive in 24.9% and non-reactive in 64.3%. A high prevalence of active syphilis was detected in patients attending the clinic. The use of a syphilis RT had a positive impact, which in combination with the VDRL test increased the number of patients that were effectively diagnosed.