ABSTRACT BACKGROUND: Given the characteristics of military missions, intense interpersonal contact, and wide variation in casual relationships, the military has long been recognized as a high-risk population for sexually transmitted infections (STIs). OBJECTIVE: To assess the prevalence of STIs and socioepidemiological profile of women in the military garrison of Campinas. DESIGN AND SETTING: This prospective, cross-sectional epidemiological study, assisted by the Health Fund in the military garrison of Campinas, assessed the prevalence of human immunodeficiency virus (HIV), hepatitis B and C, syphilis, human papillomavirus (HPV), chlamydia, and gonococcus in military women or companions of soldiers with active or previously active sexual life. METHODS: This study included 647 women based on the non-inclusion criteria. They underwent clinical and laboratory tests for diagnosis of STIs. For statistical analysis, patients were divided into groups according to the presence or absence of STIs and into age groups. RESULTS: Most women were military dependents, and the majority were asymptomatic. The prevalence of STIs, in ascending order, was 0.3% for hepatitis B and C, 0.62% for syphilis, 0.62% for gonorrhea, 1.08% for chlamydia, and 2.63% for HPV. There were no cases of HIV infection. CONCLUSIONS: The Brazilian Army has the most women-like dependents in the military, belonging to the hierarchical circle of the squares. Early onset of sexual activity favored STIs approximately twice, and younger women had approximately seven times more chlamydia infections. In the general population studied, the prevalence of STIs was lower than expected than in the armed forces of other nations.

Abstract Lymphogranuloma venereum is a sexually trans mitted disease caused by L1, L2 and L3 serovars of Chlamydia trachomatis. A rare clinical presentation of the primary stage is lymphangitis of the penis, with the appearance of one or more tense lymph nodes classically called “buboes”. We report the case of an HIV-positive patient with sexually transmitted disease risk behaviors with penile nodules as a manifestation of lymphogranuloma venereum.

Resumen El linfogranuloma venéreo es una infección de trans misión sexual (ITS) causada por las serovariedades L1, L2 y L3 de Chlamydia trachomatis. Una forma rara de presen tación del estadio primario es la linfangitis localizada en pene, con la formación de uno o más nódulos linfáticos tensos clásicamente llamados “bubonódulos” (bubón pe queño). Presentamos el caso de un paciente HIV positivo con conductas de riesgo para ITS con nódulos peneanos como manifestación de linfogranuloma venéreo.

Abstract 18. In the Republic of Benin, abortion is one of the reproductive problems on small ruminant farms, and Chlamydia abortus is one of the causative agents. The aim of this study was to determine for the first time the serological prevalence and hematological parameters in small ruminants positive for Chlamydia abortus in Benin, mainly in the department of Ouémé. It covered five sites, namely Akpro-Missérété, Avrankou, Adjarra, Sèmè-Kpodji and Dangbo in the Ouémé department. A total of 385 sera (200 sheep and 185 goats) from subjects showing signs of reproductive loss were tested using the indirect Elisa method. Of the 385 sera tested, 30 (7,79%) were positive for Chlamydia abortus. Similarly, the blood of animals tested positive was analyzed for hematological parameters using Sysmex XN-Series automated blood analyzer. Different variations with significant differences in some hematological parameters of the red line and those of the white line, depending on the study sites, species, age and physiological stage of the animals (hemoglobin, mean corpuscular volume for the red line at the sites, lymphocytes and basophils for the white line at the sites; hemoglobin for the red lineage and lymphocytes for the white lineage at species level; lymphocytes at age level; lymphocytes, monocytes and basophils for the white lineage at physiological stage level) were observed in animals suffering from C. abortus.

Resumen. 22. En la República de Benín, el aborto es uno de los problemas reproductivos de las explotaciones de pequeños rumiantes, y Chlamydia abortus es uno de los agentes causales. El objetivo de este estudio era determinar por primera vez la prevalencia serológica y los parámetros hematológicos en pequeños rumiantes positivos a Chlamydia abortus en Benín, principalmente en el departamento de Ouémé. Abarcó cinco emplazamientos, a saber, Akpro-Missérété, Avrankou, Adjarra, Sèmè-Kpodji y Dangbo, en el departamento de Ouémé. Se analizaron 385 sueros (200 ovejas y 185 cabras) de sujetos que presentaban signos de pérdida reproductiva mediante el método Elisa indirecto. De los 385 sueros analizados, 30 (7,79%) resultaron positivos para Chlamydia abortus. Del mismo modo, se analizó la sangre de los animales con resultados positivos para determinar los parámetros hematológicos utilizando el analizador de sangre automatizado Sysmex XN-Series. Se observaron variaciones con diferencias significativas en algunos parámetros hematológicos de la línea roja y los de la línea blanca, en función de los lugares de estudio, la especie, la edad y el estadio fisiológico de los animales (hemoglobina, volumen corpuscular medio para la línea roja en los lugares, linfocitos y basófilos para la línea blanca en los lugares; hemoglobina para la línea roja y linfocitos para la línea blanca a nivel de especie; linfocitos a nivel de edad; linfocitos, monocitos y basófilos para la línea blanca a nivel de estadio fisiológico) se observaron en los animales afectados por C. abortus.

ABSTRACT This study aimed to investigate the prevalence rate of brucellosis, leptospirosis, and chlamydiosis in the offspring of free-living sea lions (Zalophus californianus) in the Mexican Gulf of California. The work was carried out across six islands where reproduction takes place. Sixty-one blood samples were collected from seemingly healthy sea lions from six to eight weeks old. For diagnosis, serum was obtained by venae cavae puncture. In the search for smooth Brucella spp., based on phenotypic characterization, antigens were detected employing an antigen test for Brucella abortus, strain 1119-3. In the case of leptospirosis, the serological diagnosis was carried out by microscopic agglutination to identify 12 Leptospira interrogans serotypes. Lastly, Chlamydia abortus was identified using commercial ELISA (ID Screen®). All 61 serum samples presented negative results for the B. abortus antigen and the C. abortus ELISA. The serological diagnosis for leptospirosis showed that 29 out of 61 sera were negative (47.5%) for all serotypes, and 32 out of 61 were positive (52.5%) for at least one serotype. After studying the three diseases, results suggest that the presence of antigens against Leptospira is a potential threat to the protected sea lions from the Gulf of California.

Resumen. El loro barranquero (Cyanoliseus patagonus) se distribuye en zonas de sabana, estepa y pastizales de Chile y Argentina. En esta nota documentamos por primera vez el registro de esta especie para la ciudad de Tijuana, Baja California, México. El 14 de septiembre de 2018 tuvimos avistamientos de alrededor de 60 individuos buscando alimento en el suelo en un área comercial de la ciudad. Adicionalmente, entre febrero y octubre del 2021 registramos individuos de C. patagonus perchando sobre troncos de palma de taco (Washingtonia robusta) y ocupando oquedades excavadas en los troncos. De acuerdo con la literatura, C. patagonus naturalmente anida en acantilados, pero es capaz de incursionar en el uso de sustratos vegetales y antropogénicos para su nidificación. Recomendamos implementar un programa de monitoreo para conocer la dinámica de la población dentro de la zona urbana, ya que se trata de una especie exótica altamente gregaria y con un alto potencial de fungir como reservorio de Herpesvirus y Chlamydia psittaci, lo cual podría traer serias repercusiones a la salud pública.

Abstract. The natural distribution of the Burrowing Parrot (Cyanoliseus patagonus) includes savanna, steppe and grassland areas in Chile and Argentina. Here we report the first record of this species in Tijuana, Baja California, Mexico. On 14 September 2018, we observed around 60 individuals foraging on the ground in a commercial area of the city. Additionally, between February and October 2021 we recorded individuals of C. patagonus perched on trunks of the Mexican Fan Palm (Washingtonia robusta) and occupying cavities excavated in the trunks. According to the literature, C. patagonus naturally nests in cliffs, but is also able to use other plant and anthropogenic substrates for nesting. We recommend implementing a monitoring program to determine population dynamics of this species within the Tijuana urban area, as C. patagonus is a highly gregarious exotic species with strong potential to act as a reservoir for Herpesvirus and Chlamydia psittaci, which could have serious repercussions on public health.

Resumen Introducción: La infección por Chlamydia trachomatis es la ITS bacteriana más frecuente del mundo. En el cervix se presenta mayormente de forma asintomática y afecta especialmente a mujeres jóvenes y adolescentes. Puede producir daño permanente en el tracto reproductor femenino, se asocia a parto prematuro, infecciones neonatales transmitidas vía vertical y mayor riesgo de adquirir otras ITS como VIH Y VPH. Por estos motivos se han establecido estrategias de tamizaje para detectar y tratar precozmente la infección asintomática por C. trachomatis en diferentes países. En nuestro país no contamos con un programa nacional de tamizaje. Objetivo: Determinar la prevalencia de infección asintomática por Chlamydia trachomatis en mujeres entre 12 y 21 años de la Provincia de Osorno, Región de Los Lagos, Chile. Pacientes y Métodos: Se desarrolló un estudio de diseño transversal con una cohorte única de mujeres adolescentes y jóvenes consultantes en el Policlínico de Alto Riesgo Obstétrico y de Ginecología Infantil y Adolescente, del Hospital Base de Osorno, entre enero de 2019 y enero 2020. Se determinó el estado de infección asintomática mediante RPC en tiempo real para C. trachomatis. Se realizó una encuesta a fin de determinar características demográficas, hábitos y conductas sexuales de las pacientes estudiadas. Resultados: Fueron reclutadas 124 mujeres entre 12 a 21 años de edad, de las cuales, 36 (29,3%) se encontraban embarazadas al momento del estudio. La prevalencia de infección asintomática por C. trachomatis fue de 14/124 (11,3%). En las mujeres gestantes se encontraron 6/36 (16,7%) casos positivos de infección por C. trachomatis y 8/88 (9,1%) en las no gestantes. Existe una mayor frecuencia de infección asintomática a menor edad de inicio de actividad sexual (33,3% en aquellas que inician entre 11-12 años vs. 16,2% en las que inician entre 1314 años, 7,4% entre 15-16 y 8% entre 17-21 años; p < 0,05). Esta tendencia no fue observada al comparar el estado de infección con el tiempo de vida sexual activa. Sólo 15,7% de las pacientes utilizó preservativo en todas sus relaciones sexuales. Discusión: La infección asintomática por C. trachomatis es frecuente en las mujeres adolescentes y jóvenes sexualmente activas. Las pacientes con inicio más temprano de la actividad sexual coital (bajo 13 años de edad) podrían estar en mayor riesgo. Se requiere con urgencia establecer la frecuencia nacional de infección para desarrollar una estrategia sanitaria para su pesquisa y manejo oportuno en nuestro país.

Abstract Background: Chlamydia trachomatis infection is the world most common bacterial STI. At uterine cervix it presents mostly asymptomatically and especially affects young women and adolescents. It can cause permanent damage to the female reproductive tract and is associated with premature birth, connatal infections and increased risk of acquiring other STIs such as HIV and HPV. For these reasons, other countries have established screening strategies to detect and treat asymptomatic C. trachomatis infection. Our country don’t have a national screening program. Aim: To determine the prevalence of C. trachomatis asymptomatic infection in adolescent and young women in Osorno province, Los Lagos Region, Chile. Methods: A crosssectional study was performed in adolescent and young women who consult at Hospital Base Osorno in the MaternoFetal and PediatricAdolescent Gynecology ambulatory clinics, between January 2019 and January 2020. The status of asymptomatic infection was determined by PCR for C. trachomatis. A survey was carried out to determine the demographic characteristics, habits and sexual behaviors. Results: 124 women between 12 and 21 years of age were recruited, of which 36 (29,3%) were pregnant at the time of the study. The prevalence of asymptomatic infection by C. trachomatis was 11.3.%. In pregnant women, there were 6/36 (16.7%) positive cases for C. trachomatis and 8/88 (9.1%) in nonpregnant women. We found a higher frequency of asymptomatic infection at younger age of first sexual intercourse (33% in adolescents at 11-12 years old vs. 16.2% at 13-14, 7.4% at 15-16 and 8% at 17-21; p<0.05). Only 15.7% of the patients utilized condoms in all their intercourses. Discussion: Asymptomatic C. trachomatis infection is common in adolescent and young women, with a higher risk in those who onset sexual activity at an early age (less than 13 years old). It is urgently required to determine the national frequency of asymptomatic C. trachomatis infection to develop a national strategy for screening and timely treatment.

BACKGROUND: Sexually transmitted infections (STIs) are a global public health concern and sub-Saharan Africa, has limited data on STIs in the men who have sex with men (MSM) population. Syndromic management has controversies for treating asymptomatic STIs (ASTIs AIM: The aim of this study was to describe the risk factors for STIs among MSM SETTING: This study was conducted in Tshwane North, Gauteng Province in South Africa METHODS: A cross-sectional quantitative design was employed using structured questionnaires, rapid plasma reagent test, from December 2021 to May 2022. Bivariate and multivariate analyses were used for statistical analysis RESULTS: A total of 200 MSM with the mean age of 27.6, standard deviations: 6.8 participated, and STIs prevalence was 66%, with 37% concurrent infections. Ureaplasma urealyticum was (24%), Mycoplasma hominis (23%), Chlamydia trachomatis (20%), Treponema pallidum (20%) and Neisseria gonorrhoeae (9%). The risk factors for acquisition of STI include having a new partner in the last month (OR = 1.68; CI: 0.98-3.13 CONCLUSION: The prevalence of ASTIs is high. Serial and multiple sexual partners are the risk factors CONTRIBUTION: This study contributes to the body of knowledge of the burden of STIs among high-risk population

Abstract Background The factors associated with bacterial vaginosis in women with homosexual, bisexual and heterosexual practices are still poorly explored. Thus, the aim of this study was to analyze the factors associated with bacterial vaginosis in women with different sexual practices. Methods Cross-sectional study that included 453 women, 149 Women with Homosexual practice (WSW); 80 bisexual Women (WSWM) and 224 Women with heterosexual practice (WSM). The diagnosis of bacterial vaginosis was performed by microscopic examination of the vaginal smears stained by Gram method and classified according to the Nugent et al. (1991) score. Data analysis was performed by Cox multiple regression. Results Bacterial vaginosis was associated to years of education among WSW (0.91 [95% CI 0.82‒0.99]; p= 0.048) and non-white skin color (2.34 [95% CI 1.05‒5.19]; p= 0.037) between WSWM. Changing partners in the last 3-months (2.09 [95% CI 1.14‒3.82]; p= 0.017), inconsistent use of condoms (2.61 [95% CI 1.10‒6.20]; p= 0.030) and positive diagnosis of Chlamydia trachomatis (2.40 [95% CI 1.01‒5.73]; p= 0.048) were associated with bacterial vaginoses only in WSH. Conclusions The factors associated to bacterial vaginosis differ between different sexual practices, suggesting that the type of sexual partner may influence the risk of developing this classic dysbiosis.

RESUMO Esta pesquisa teve como objetivo investigar a ocorrência de Chlamydia sp., Morbillivirus sp., Parvovirus sp., Leishmania sp. e Alphacoronavirus sp. em tamanduás-bandeira cativos. Foram colhidas amostras de sangue e fezes de 16 animais em instituições dos estados de Minas Gerais, Bahia e Distrito Federal, que estavam em cativeiro há pelo menos um ano. Um teste comercial rápido de imunoensaio cromatográfico foi usado para detectar antígenos de coronavírus e parvovírus, além de anticorpos contra a leishmaniose, sendo todos os resultados negativos. No caso do teste para anticorpos contra a doença, quatro (4/16; 25%) tamanduás apresentaram titulação média, dois (2/16; 12,5%) uma titulação baixa e dez (10/16; 62,5%) não foram reativos. A partir do método DOT-ELISA (dot blotting) para detecção de imunoglobulina G, apenas um espécime obteve uma titulação de 1: 40. Para os testes de reação em cadeia da polimerase para Leishmania e Chlamydia, todas as amostras foram negativas.

ABSTRACT This research aimed to investigate the occurrence of Chlamydia sp., Morbillivirus sp., Parvovirus sp., Leishmania sp. and Alphacoronavirus sp. in captive giant anteaters. Blood and fecal samples were taken from 16 animals in institutions from the states of Minas Gerais, Bahia and Distrito Federal, which had been in captivity for at least a year. A commercial rapid chromatographic immunoassay test was used for detecting coronavirus and parvovirus antigens, in addition to antibodies against leishmaniasis, all results being negative. In the case of the test for antibodies against distemper, four (4/16; 25%) anteaters had an average titration, two (2/16; 12.5%) a low titration and ten (10/16; 62.5%) were non-reactive. Using the DOT-ELISA (dot blotting) method for detection of immunoglobulin G, only one specimen obtained a 1 : 40 titration. For the polymerase chain reaction tests for Leishmania and Chlamydia, all samples were negative.

Abstract Genital ulcers (GUs) represent a diagnostic challenge and can be secondary to neoplastic and inflammatory processes of different causes. Among those of infectious etiology, there are sexually transmitted infections (STIs), a very frequent reason for seeking the health service. The most common agents are herpes simplex virus and Treponema pallidum and, more rarely, Haemophilus ducreyi, Klebsiella granulomatis and Chlamydia trachomatis. A careful dermatological examination offers important diagnostic elements; however, atypical manifestations are very common. Distinctive characteristics of ulcers to look out for include their margin, edge, bottom, and base. Regional lymph node chain alterations should be evaluated regarding their number, size, mobility, consistency, inflammation, and pain on palpation. Diagnostic tests have variable sensitivity and specificity, and molecular tests are currently considered the reference exams. The rapid immunochromatographic tests represented a significant advance, as they can be performed with blood obtained from the digital pulp, offer results in up to 30 minutes, and do not require a laboratory structure. The treatment of persons affected by GU/STIs must be immediate, as it aims to prevent complications, as well as reduce transmission. It is not always considered that people with GUs/STIs have varying degrees of depression, anxiety, and self-reproach, with an impact on relationships. Establishing a bond and trusting the professional is essential for adherence to treatment and preventive measures that must be discussed individually.

Abstract The species that make up the genus Chlamydia affect a wide range of animal hosts, causing various pathologies. Chlamydia abortus (C. abortus), Chlamydia psittaci (C. psittaci) and Chlamydia pecorum (C. pecorum) are the most clinically relevant in small ruminants worldwide, since they have been related to reproductive, ocular and digestive tract problems respectively; two of these (C. abortus and C. psittaci) represent a potential zoonotic risk to humans. The diagnosis of infections by organisms of this genus is complicated; since, in most cases, there are no clinical signs that indicate the presence of the agent in affected animals. Currently, in European countries, the prevention and control mainly of C. abortus is carried out through the administration of commercial attenuated immunogens; however, their use has not shown satisfactory results in the protection of susceptible animals. Therefore, the implementation of new immunization options based on the utilization of recombinant proteins is the line of research that is currently taking the most prominence. Additionally, the use of proteins with immunogenic potential could be important tools for the diagnosis, prevention and control of these pathogens. Due to this, the present review focused on recapitulating the most current studies focused on the experimental use of different immunogenic proteins of Chlamydia spp. used worldwide, highlighting their innovation and results obtained in experimental models.

Resumen Las especies que conforman el género Chlamydia afectan una amplia gama de hospederos animales, causando diversas patologías. Chlamydia abortus (C. abortus), Chlamydia psittaci (C. psittaci) y Chlamydia pecorum (C. pecorum) son las de mayor relevancia clínica en pequeños rumiantes a nivel mundial, ya que han sido relacionadas con problemas reproductivos, oculares y del tracto digestivo respectivamente; dos de estas (C. abortus y C. psittaci), representan un riesgo potencial zoonótico al ser humano. El diagnóstico de infecciones por organismos de este género resulta complicado; ya que, en la mayoría de los casos no hay signología clínica que indique la presencia del agente en animales afectados. Actualmente en países europeos la prevención y control principalmente de C. abortus se realiza mediante la administración de inmunógenos atenuados comerciales; sin embargo, su uso no ha mostrado resultados satisfactorios en la protección de animales susceptibles. Por lo tanto, la implementación de nuevas opciones de inmunización basadas en la utilización de proteínas recombinantes es la línea de investigación que más realce está tomando actualmente. Adicionalmente, el uso de proteínas con potencial inmunogénico podrían ser herramientas importantes para el diagnóstico, prevención y control de estos patógenos. Debido a esto, la presente revisión se centró en recapitular los estudios más actuales enfocados al uso experimental de diferentes proteínas inmunogénicas de Chlamydia spp. empleadas a nivel mundial, destacando su innovación y resultados obtenidos en los modelos experimentales.

Resumen Los patógenos bacterianos pueden detectarse en las infecciones respiratorias virales y son una causa importante de morbimortalidad. La prevalencia de Chlamydia pneumoniae en pacientes infectados con SARS-CoV-2 ha sido poco estudiada. El objetivo de la presente revisión fue describir la prevalencia de C. pneumoniae en pacientes con enfermedad por coronavirus 2019 (COVID-19). Para ello se realizó una búsqueda bibliográfica en Medline y Google Académico, entre enero de 2020 y agosto de 2021. De la revisión surgieron 11 artículos (cinco estudios de casos transversales y seis estudios retrospectivos), que incluyeron un total de 18.450 pacientes. La detección de C. pneumoniae varió entre el 1,78 y 71,4% del total de las coinfecciones. La media de edad de los pacientes osciló entre los 35 y 71 años y el 65% fueron hombres. En la mayoría de los estudios se informaron comorbilidades preexistentes y la mayor parte de los pacientes presentó fiebre, tos y disnea. Además, se describió linfopenia y eosinofilopenia en pacientes con COVID-19 coinfectados. La principal manifestación en la tomografía computarizada fue densidad de vidrio esmerilado, consolidación y neumonía bilateral. La mayoría de los pacientes recibió antibióticos de manera empírica. La coinfección bacteriana no se asoció con un aumento de ingresos en cuidados intensivos ni mortalidad. A pesar de la prescripción de antimicrobianos empíricos en pacientes con infecciones respiratorias asociadas a coronavirus existen pocos reportes de detección de coinfección bacteriana. Es necesario generar evidencia para el desarrollo de políticas antimicrobianas e intervenciones de administración apropiadas y específicas en la pandemia de COVID-19.

Abstract Bacterial co-pathogens are commonly identified in viral respiratory infections and are important causes of morbid-mortality. The prevalence of Chlamydia (C.) pneumoniae infection in patients infected with SARS-CoV-2 has not been sufficiently studied. The objective of the present review was to describe the prevalence of C. pneumoniae in patients with coronavirus disease 2019 (COVID-19). A search in MEDLINE and Google Scholar databases for English language literature published between January 2020 and August 2021 was performed. Studies evaluating patients with confirmed COVID-19 and reporting the simultaneous detection of C. pneumoniae were included. Eleven articles were included in the systematic review (5 case cross-sectional studies and 6 retrospective studies). A total of 18450 patients were included in the eleven studies. The detection of laboratory-confirmed C. pneumoniae infection varied between 1.78 and 71.4% of the total number of co-infections. The median age of patients ranged from 35 to 71 years old and 65% were male. Most of the studies reported one or more pre-existing comorbidities and the majority of the patients presented with fever, cough and dyspnea. Lymphopenia and eosinopenia were described in COVID-19 co-infected patients. The main chest CT scan showed a ground glass density shadow, consolidation and bilateral pneumonia. Most patients received empirical antibiotics. Bacterial co-infection was not associated with increased ICU admission and mortality. Despite frequent prescription of broad-spectrum empirical antimicrobials in patients with coronavirus 2-associated respiratory infections, there is a paucity of data to support the association with respiratory bacterial co-infection. Prospective evidence generation to support the development of an antimicrobial policy and appropriate stewardship interventions specific for the COVID-19 pandemic are urgently required.

Resumen Introducción. La infección genital por Chlamydia trachomatis es una de las más frecuentes en el mundo. Cada año se registran cerca de 85 millones de nuevos casos de esta enfermedad, que cursa con graves complicaciones en la mujer y recién nacido. Objetivo. Determinar las características clínico-epidemiológicas de la infección por C. trachomatis en mujeres venezolanas sexualmente activas. Materiales y métodos. Es un estudio descriptivo, transversal y de campo, sustentado en la historia clínica y el examen físico, la detección de infección con la prueba inmunoenzimática con anticuerpos policlonales anti-LPS y la confirmación de los resultados con la de biología molecular. La muestra estuvo conformada por 100 mujeres sexualmente activas mayores de 12 años de edad, del estado Carabobo, Venezuela. Resultados. La mayoría de las mujeres se encontraba entre los 20 y los 45 años de edad. En el 25 % de las mismas, se detectaron anticuerpos IgG anti-C. trachomatis y, en el 84 % de estas, se confirmó la infección mediante PCR; en ninguna de las mujeres se hallaron anticuerpos IgM anti-C. trachomatis. Conclusión. La infección crónica predomina en las mujeres entre los 20 y los 45 años de edad; la prueba inmunoenzimática arrojó falsos positivos corroborados por PCR.

Abstract Introduction: Genital Chlamydia trachomatis infection is one of the most frequent in the world; about 85 million new cases of this pathology are registered each year, which causes severe complications in women and newborns. Objective: To determine the clinical-epidemiological characteristics of C. trachomatis infection in sexually active Venezuelan women. Materials and methods: Descriptive, cross-sectional, and field study based on the clinical history and physical examination, detection of infection with immunoenzymatic assay with anti-LPS polyclonal antibody and confirmation of results with molecular biology test. The sample consisted of 100 sexually active women over 12 years of age from Carabobo state, Venezuela. Results: The women were mostly between 20 and 45 years old, in 25% of them IgG antibodies to C. trachomatis were detected and in 84% of these the infection was confirmed by PCR, in none of the women IgM antibodies to C. trachomatis were found. Conclusion: Chronic infection characterizes women between 20 and 45 years of age; the immunoenzymatic test yielded false positives corroborated by PCR.

Abstract Background: Chlamydia trachomatis-lymphogranuloma venereum (LGV) is a sexually transmitted infection (STI) and an uncommon cause of proctitis. The diagnosis requires a high index of clinical suspicion, since the clinical, imaging, endoscopic, and histological findings can mimic multiple benign or malignant conditions like inflammatory bowel disease and rectal neoplasms. Case Presentation: We present the case of a 48-year-old Caucasian male with no significant previous medical history who was admitted due to the suspicion of a rectal neoplasia. He underwent an abdominopelvic computed tomography (CT) scan and pelvic magnetic resonance imaging (MRI) before admission due to complaints of anorectal pain, hematochezia, and constipation over the previous 2 weeks. The examination revealed a circumferential rectal wall thickening, infiltration of the perirectal fat and invasion of the mesorectal fascia, associated with perirectal fat lymphadenopathy. A radiological diagnosis of a rectal malignant neoplasia staged as T4N2MX was stated. Digital rectal examination identified a circumferential rectal tumor. Rectosigmoidoscopy showed an extensive and circumferential ulceration of the rectal mucosa, with elevated geographical borders, exudate, and aphthoid erosions at the proximal limit of the endoscopic mucosal ulceration. Biopsy specimens revealed acute ulcerative proctitis with lymphoplasmocytic inflammatory infiltrate but no evidence of dysplasia or malignancy. A STI screening was positive for HIV-1 (CD4+ 251/mm3; N = 700-1,100) and C. trachomatis, with an elevated IgA-specific antibody titer (52.000; N < 5.0), suggesting LGV disease. The diagnosis was confirmed by the identification of C. trachomatis DNA on rectal swab. Other infectious causes of acute proctitis were excluded. When faced with these results, the patient ended up mentioning that he had unprotected anal sex with men. He started treatment with doxycycline 100 mg twice a day for 21 days, with a drastic improvement. Rectosigmoidoscopy was repeated and showed clear signs of progressive resolution of the ulcerative proctitis. Discussion: LGV-associated proctitis, often undervalued, is a reemerging disease which should always be considered a benign cause of rectal mass, in order to avoid delay in diagnosis and development of complications. Diagnosis becomes more challenging in patients with unknown HIV status. A detailed clinical history, including sexual behaviors, is a vital step to achieve the final diagnosis.

Resumo Introdução: A infeção por Chlamydia trachomatis-linfogranuloma venéreo (LGV) é uma doença sexualmente transmissível (DST), sendo uma causa incomum de proctite. O diagnóstico exige um elevado grau de suspeição, dado que os achados clínicos, radiológicos, endoscópicos e histológicos podem mimetizar múltiplas condições benignas ou malignas, como a doença inflamatória intestinal e as neoplasias retais. Caso clínico: Apresentamos o caso de um homem de 48 anos, caucasiano, sem antecedentes relevantes, admitido por suspeita de neoplasia retal. Por queixas de dor anorretal, hematoquézias e obstipação com 2 semanas de evolução, realizou uma tomografia computadorizada abdominopélvica e uma ressonância magnética pélvica, que revelaram espessamento retal circunferencial, infiltração da gordura periretal e invasão da fáscia mesoretal, associados a linfadenopatias locais, sugestivos de malignidade retal (T4N2MX). O toque retal identificou uma tumoração retal circunferencial. A retosigmoidoscopia mostrou mucosa retal com ulceração extensa e circunferencial, bordos geográficos elevados, exsudado e erosões aftóides no limite proximal da ulceração mucosa. As biópsias revelaram proctite ulcerada aguda com infiltrado linfoplasmocitário difuso, sem displasia ou neoplasia. O screening de DST foi positivo para VIH-1 (CD4+ 251/mm3; N:700-1100) e título elevado de IgA para C. trachomatis (52 000; N<5), sugerindo LGV. O diagnóstico foi confirmado pela identificação do DNA de C. trachomatis em zaragatoa retal. Outras causas infecciosas de proctite aguda foram excluídas. Perante estes resultados, o doente acabou por mencionar que tinha tido relações homossexuais anais desprotegidas. Iniciou doxiciclina (100 mg duas vezes por dia, por 21 dias) com melhoria sintomática drástica. Repetiu retosigmoidoscopia, com sinais de proctite ulcerada em resolução. Discussão: A proctite por LGV, frequentemente desvalorizada, é uma doença re-emergente, que deve ser sempre equacionada como causa benigna de massa retal, de modo a evitar o atraso diagnóstico e o desenvolvimento de complicações. O diagnóstico torna-se mais desafiante em doentes com status VIH desconhecido. A história clínica detalhada, incluindo comportamentos sexuais de risco, é fundamental para o diagnóstico.

Resumen Introducción: La presencia de bacterias en semen (bacteriospermia) es una condición patológica asociada con infertilidad y con prevalencia de hasta el 35%. Objetivo: Reportar el caso de un paciente con oligoastenozoospermia manejado en la consulta de infertilidad. Caso: Paciente masculino de 33 años de edad con historia de dificultad para la concepción, antecedente de orquiectomía por torsión testicular a los 16 años, infección por Chlamydia trachomatis a los 20 años. Examen físico normal, ecografía doppler testicular con varicocele izquierdo leve. Espermograma con oligoastenozoospermia y espermocultivo en agar sangre positivo para Streptococcus spp y agar chocolate para Streptococcus spp. Se inició manejo con ampicilina Sulbactam durante 14 días y control a los 3 meses con nuevo espermograma con mejoría marcada de la concentración y la movilidad progresiva espermática. Resultado: La pareja logro un embarazo exitoso con bebe vivo en casa. Conclusión: La colonización bacteriana del semen contribuye a alteraciones de la calidad seminal, por lo tanto, determinar la presencia de bacterias en las parejas infértiles podría ser de utilidad para el mejoramiento de los parámetros seminales y lograr un embarazo exitoso.

Abstract The presence of bacteria in semen -bacteriospermia- is a pathological condition associated with infertility, which presents a prevalence of up to 35%. We describe the successful management during infertility consultation of a patient suffering from oligoasthenozoospermia. A 33-year-old male patient with a history of difficulty conceiving, a history of orchiectomy due to testicular torsion at 16 years of age, and Chlamydia trachomatis infection at 20 years of age. The physical examination showed normal results, and testicular Doppler ultrasonography presented mild left varicocele. The semen analysis reported oligoasthenozoospermia, positive semen culture on blood agar for Streptococcus spp, and positive chocolate agar for Streptococcus spp. The treatment started with ampicillin-sulbactam administration for 14 days and a check-up after three months with a new semen analysis which showed an improved concentration and progressive sperm motility. Finally, the couple achieved a successful pregnancy. Bacterial colonization of semen contributes to seminal quality alterations; therefore, determining bacteria's presence in infertile couples could help improve seminal parameters and achieve a successful pregnancy.