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Reviews of Infectious Diseases 1988Fifty-seven episodes of anorectal infection in 44 patients with malignant diseases primarily leukemia or lymphoma, have been retrospectively reviewed. Seventeen patients...
Fifty-seven episodes of anorectal infection in 44 patients with malignant diseases primarily leukemia or lymphoma, have been retrospectively reviewed. Seventeen patients died in hospital, but only in seven cases was the anorectal infection a major contributing cause of death. The most important prognostic indicator of outcome was number of days of neutropenia during the infectious episode. Cultures obtained at the time of surgical drainage or by needle aspiration of the wound revealed multiple organisms in 26 of 29 instances, and anaerobic organisms were the commonest isolates. Anorectal infection was controlled in 28 (55%) of 51 treatment courses when antibiotics were the only treatment given. However, if the antibiotic regimen included both an aminoglycoside and an antibiotic with anaerobic coverage, control of infection was observed in 15 (88%) of 17 cases. There were 26 surgical procedures performed, with acceptable morbidity. Infection was controlled in 19 (73%) of 26 cases treated with surgery and antibiotics. The results support managing most of these infections initially with medical treatment, using an antibiotic regimen that includes an aminoglycoside and a specific drug against anaerobes. Surgery is recommended if there is obvious fluctuance, a significant amount of necrotic tissue evident, or progression of the infection locally or continued sepsis after an adequate antibiotic trial.
Topics: Adolescent; Adult; Anti-Bacterial Agents; Anus Diseases; Bacterial Infections; Child; Child, Preschool; Combined Modality Therapy; Drainage; Female; Humans; Immune Tolerance; Leukemia; Leukocyte Count; Lymphoma; Male; Middle Aged; Neoplasms; Neutropenia; Neutrophils; Rectal Diseases; Retrospective Studies
PubMed: 3353632
DOI: 10.1093/clinids/10.1.42 -
Journal of Lower Genital Tract Disease Jul 2015The incidence of anal cancer is higher in women than men in the general population and has been increasing for several decades. Similar to cervical cancer, most anal... (Review)
Review
OBJECTIVE
The incidence of anal cancer is higher in women than men in the general population and has been increasing for several decades. Similar to cervical cancer, most anal cancers are associated with human papillomavirus (HPV), and it is believed that anal cancers are preceded by anal high-grade squamous intraepithelial lesions (HSIL). Our goals were to summarize the literature on anal cancer, HSIL, and HPV infection in women and to provide screening recommendations in women.
METHODS
A group of experts convened by the American Society for Colposcopy and Cervical Pathology and the International Anal Neoplasia Society reviewed the literature on anal HPV infection, anal SIL, and anal cancer in women.
RESULTS
Anal HPV infection is common in women but is relatively transient in most. The risk of anal HSIL and cancer varies considerably by risk group, with human immunodeficiency virus-infected women and those with a history of lower genital tract neoplasia at highest risk compared with the general population.
CONCLUSIONS
While there are no data yet to demonstrate that identification and treatment of anal HSIL leads to reduced risk of anal cancer, women in groups at the highest risk should be queried for anal cancer symptoms and required to have digital anorectal examinations to detect anal cancers. Human immunodeficiency virus-infected women and women with lower genital tract neoplasia may be considered for screening with anal cytology with triage to treatment if HSIL is diagnosed. Healthy women with no known risk factors or anal cancer symptoms do not need to be routinely screened for anal cancer or anal HSIL.
Topics: Anus Neoplasms; Early Detection of Cancer; Female; Humans; Papillomavirus Infections; Risk Factors; Squamous Intraepithelial Lesions of the Cervix
PubMed: 26103446
DOI: 10.1097/LGT.0000000000000117 -
The British Journal of Surgery Aug 1990Human immunodeficiency virus has resulted in a major change in the presentation and behaviour of certain common diseases in Africa. This review describes some of the... (Review)
Review
Human immunodeficiency virus has resulted in a major change in the presentation and behaviour of certain common diseases in Africa. This review describes some of the important changes and discusses the implications for management.
Topics: Africa; Female; HIV Infections; Humans; Male; Opportunistic Infections; Surgical Wound Infection; Wound Healing
PubMed: 2203506
DOI: 10.1002/bjs.1800770806 -
Clinical Infectious Diseases : An... Nov 2009Human immunodeficiency virus (HIV)-infected men who have sex with men (MSM) were enrolled in an anorectal Chlamydia trachomatis screening study. Anorectal Chlamydia DNA...
Human immunodeficiency virus (HIV)-infected men who have sex with men (MSM) were enrolled in an anorectal Chlamydia trachomatis screening study. Anorectal Chlamydia DNA was detected in 16 (10.9%) of 147 men, mainly among asymptomatic patients and patients having >20 sexual partners. These results support routine anorectal Chlamydia screening in HIV-infected MSM who report unprotected anal intercourse.
Topics: Adult; Aged; Anus Diseases; Chlamydia Infections; Chlamydia trachomatis; DNA, Bacterial; HIV Infections; Homosexuality, Male; Humans; Male; Middle Aged; Polymerase Chain Reaction; Prevalence; Rectal Diseases; Switzerland; Young Adult
PubMed: 19848599
DOI: 10.1086/644740 -
Gastroenterology Clinics of North... Dec 2013Sexually transmitted diseases (STDs) are common and they can involve the anus and rectum in both men and women. In this article, the main bacterial and viral STDs that... (Review)
Review
Sexually transmitted diseases (STDs) are common and they can involve the anus and rectum in both men and women. In this article, the main bacterial and viral STDs that affect the anus and rectum are discussed, including their prevalence, presentation, and treatment.
Topics: Anus Diseases; Chancroid; Condylomata Acuminata; Female; Gonorrhea; Granuloma Inguinale; HIV Infections; Herpes Simplex; Humans; Lymphogranuloma Venereum; Male; Papillomavirus Infections; Proctitis; Sexual Behavior; Sexually Transmitted Diseases; Syphilis
PubMed: 24280405
DOI: 10.1016/j.gtc.2013.09.003 -
International Journal of STD & AIDS Oct 2018The objective of this article is to describe the epidemiology of lymphogranuloma venereum (LGV) and non-LGV Chlamydia trachomatis anorectal infections in France and to... (Observational Study)
Observational Study
The objective of this article is to describe the epidemiology of lymphogranuloma venereum (LGV) and non-LGV Chlamydia trachomatis anorectal infections in France and to examine the characteristics of the affected populations via a voluntary sentinel surveillance system for LGV between 2010 and 2015. Anorectal samples positive for C. trachomatis (CT) were sent by the participating laboratories to the National Reference Center for CT for LGV identification. Biological and clinical data were collected by biologists and clinicians. There were 1740 LGV episodes and 2248 non-LGV episodes. Continuous monitoring highlighted a sharp increase in the number of LGV and non-LGV anorectal infections, which were 2.3-fold and 6.5-fold, respectively. Most of the infections occurred in men who have sex with men. LGV patients were older than non-LGV patients and were more frequently human immunodeficiency virus (HIV)-positive compared to non-LGV patients. Anorectal LGV was significantly associated with residence in Paris, HIV co-infection, concurrent syphilis and bloody anal discharge. Undocumented patient characteristics were strongly associated with anorectal LGV. The anorectal LGV epidemic is poorly controlled in France. Early detection and prompt treatment of patients and their sexual partners are required to prevent transmission in the context of pre-exposure prophylaxis (PrEP) for HIV infection.
Topics: Adolescent; Adult; Age Distribution; Aged; Chlamydia Infections; Chlamydia trachomatis; France; HIV Infections; Heterosexuality; Homosexuality, Male; Humans; Lymphogranuloma Venereum; Male; Middle Aged; Polymerase Chain Reaction; Rectal Diseases; Sentinel Surveillance; Sexual Partners; Young Adult
PubMed: 29973128
DOI: 10.1177/0956462418785266 -
Sexually Transmitted Infections Aug 2019There has been considerable discussion about anorectal (CT) in women, with some calling for anorectal CT screening, but little about anorectal (NG). Given that... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
There has been considerable discussion about anorectal (CT) in women, with some calling for anorectal CT screening, but little about anorectal (NG). Given that urogenital NG is more strongly associated with pelvic inflammatory disease, this is an evidence gap. This systematic review and meta-analysis investigates the associations between anorectal CT in women and CT positivity at other sites (urogenital/oropharyngeal) and with anal intercourse, and compares these with anorectal NG within the same study populations.
METHODS
Electronic databases were searched for English-language studies published to October 2018 using the following terms: ("Chlamydia" OR "") AND (("anal" OR "rect*" OR "anorect*") OR ("extra?genital" OR "multi?site")). Studies were included if anorectal NG data were available. Random-effects meta-analyses calculated pooled estimates; heterogeneity was investigated using meta-regression.
RESULTS
25 studies were eligible. Anorectal CT positivity ranged from 0% to 17.5%, with a summary estimate of 8.0% (95% CI 7.0 to 9.1; I=88.5%). Anorectal NG positivity ranged from 0% to 17.0%, with a summary estimate of 2.1% (95% CI 1.6 to 2.8; I=92.7%). The association between urogenital and anorectal positivity was stronger for NG than CT (summary prevalence ratio (PR)=89.3 (95% CI 53.1 to 150.3; I=80.1%), PR=32.2 (95% CI 25.6 to 40.7; I=70.3%), respectively), and between oropharyngeal and anorectal positivity it was stronger for NG than CT (PR=34.8 (95% CI 10.2 to 118.2; I=89.9%), PR=8.8 (95% CI 6.8 to 11.5; I=58.1%), respectively). Anal intercourse was associated with anorectal NG (PR=4.3; 95% CI 2.2 to 8.6; I=0.0%) but not with anorectal CT (PR=1.0; 95% CI 0.7 to 1.4; I=0.0%).
CONCLUSIONS
Anorectal CT is more common than anorectal NG, but anorectal NG is more strongly associated with anal intercourse, urogenital and oropharyngeal NG, suggesting that ongoing discussion about anorectal CT should also include NG. Longitudinal data are required to further understanding of the aetiology of anorectal STIs and assess whether anorectal screening is needed in women.
TRIAL REGISTRATION NUMBER
CRD42df017080188.
Topics: Adolescent; Adult; Anal Canal; Chlamydia Infections; Chlamydia trachomatis; Female; Gonorrhea; Humans; Male; Middle Aged; Neisseria gonorrhoeae; Rectum; Sexual Behavior; Sexual Partners; Women; Young Adult
PubMed: 31097677
DOI: 10.1136/sextrans-2018-053950 -
European Urology May 2003To document the characteristics of epididymitis in boys with anorectal malformations.
OBJECTIVE
To document the characteristics of epididymitis in boys with anorectal malformations.
METHODS
Sixty-six boys with anorectal malformation were treated between January 1990 and January 2000, in our center. Four of these boys experienced epididymitis attacks. The first three patients had rectourinary fistula and the fourth had a low type anorectal malforation without a rectourinary fistula.
RESULTS
Patients were followed up for seven to nine years and epididymitis did not recur after the definitive operation in the first three patients. The fourth patient had four other episodes of epididymitis postoperatively and no reason for these episodes could be found during the further urological evaluation. Two patients had urinary tract infection and one patient had urinary tract contamination during their episodes of epididymitis.
CONCLUSION
The cause of the epididymitis can be anorectal malformation with rectourethral fistula itself or another urogenital anomaly that is associated with anorectal malformation. There is a relationship between urinary tract infection and epididymitis in these patients.
Topics: Diagnosis, Differential; Epididymitis; Humans; Infant; Male; Rectal Fistula; Recurrence; Urinary Fistula; Urinary Tract Infections
PubMed: 12706006
DOI: 10.1016/s0302-2838(03)00057-5 -
American Family Physician Nov 2012Neisseria gonorrhoeae causes urogenital, anorectal, conjunctival, and pharyngeal infections. Urogenital tract infections are most common. Men with gonorrhea may present... (Review)
Review
Neisseria gonorrhoeae causes urogenital, anorectal, conjunctival, and pharyngeal infections. Urogenital tract infections are most common. Men with gonorrhea may present with penile discharge and dysuria, whereas women may present with mucopurulent discharge or pelvic pain; however, women often are asymptomatic. Neonatal infections include conjunctivitis and scalp abscesses. If left untreated, gonorrhea may cause pelvic inflammatory disease in women, or it may disseminate, causing synovial and skin manifestations. Urogenital N. gonorrhoeae infection can be diagnosed using culture or nucleic acid amplification testing. Urine nucleic acid amplification tests have a sensitivity and specificity comparable to those of cervical and urethral samples. Fluoroquinolones are no longer recommended for the treatment of gonorrhea because of antimicrobial resistance. A single intramuscular injection of ceftriaxone, 250 mg, is first-line treatment for uncomplicated urogenital, anorectal, or pharyngeal gonococcal infections. This dosage is more effective for common pharyngeal infections than the previously recommended dose of 125 mg. Ceftriaxone should routinely be accompanied by azithromycin or doxycycline to address the likelihood of coinfection with Chlamydia trachomatis. Azithromycin may be used as an alternative treatment option for patients with previous allergic reactions to penicillin, but because of the likelihood of antimicrobial resistance, its use should be limited. Gonococcal infection should prompt physicians to test for other sexually transmitted infections, including human immunodeficiency virus. Because of high reinfection rates, patients should be retested in three to six months. The U.S. Preventive Services Task Force recommends screening for gonorrhea in all sexually active women at increased risk of infection. It also recommends intensive behavioral counseling for persons with or at increased risk of contracting sexually transmitted infections. Condom use is an effective strategy to reduce the risk of infection.
Topics: Anti-Bacterial Agents; Azithromycin; Ceftriaxone; Condoms; Diagnosis, Differential; Drug Resistance, Bacterial; Family Practice; Female; Female Urogenital Diseases; Gonorrhea; Humans; Injections, Intramuscular; Male; Male Urogenital Diseases; Practice Guidelines as Topic
PubMed: 23157146
DOI: No ID Found -
The American Journal of Surgical... Nov 2010Anorectal Hodgkin lymphoma (HL) is rare, mainly described in human immunodeficiency virus (HIV) patients with exceptional cases reported in immunocompetents. We report...
Anorectal Hodgkin lymphoma (HL) is rare, mainly described in human immunodeficiency virus (HIV) patients with exceptional cases reported in immunocompetents. We report the case of a middle age HIV male, presenting with intestinal occlusion. Rectosigmoidoscopy showed multiple anorectal nodular and ulceronecrotic masses. The biopsy specimens revealed a diffuse polymorphous inflammatory infiltrate in the lamina propria, associated with CD30, CD20, CD3, CD15, and ALK1 scattered large Hodgkin and/or Reed Sternberg -like cells stained by LMP1 antibody and EBER. A diagnosis of EBV-associated atypical lymphoproliferative disease mimicking HL was made. These lesions remained stable for 2 years without treatment then disappeared leaving a mucosal scar. A later control biopsy showed a condylomatous lesion, without lymphoid lesion, suggesting a sexually acquired infection. Eight years later, the complete resolution of the lesion without any treatment is a strong argument against a malignant lymphoid process and raises doubts as to the reality of isolated anorectal HL in immunocompetent participants.
Topics: Anus Diseases; Biopsy; DNA, Viral; Diagnosis, Differential; Epstein-Barr Virus Infections; Herpesvirus 4, Human; Hodgkin Disease; Humans; Immunocompetence; Immunohistochemistry; In Situ Hybridization; Lymphoproliferative Disorders; Male; Rectal Diseases; Remission, Spontaneous; Sexually Transmitted Diseases, Viral; Sigmoidoscopy; Time Factors
PubMed: 20861713
DOI: 10.1097/PAS.0b013e3181eded23