Multiple lesions of erythema migrans in a “Christmas tree” pattern as a presenting sign of Lyme disease
The “Christmas tree” orientation of scaling lesions along the skin tension (Langer) lines in pityriasis rosea is well known. This pattern is best appreciated on complete examination of the trunk, in which the eruption follows the long axis of the V-shaped lines of the upper chest and back, emanating around the axillae, and running transversely along the abdominal wall and lower back. Secondary syphilis has a similar presentation. When patients present with asymptomatic, larger, nonscaling patches along Langer lines, another condition deserves diagnostic consideration.
AbstractLyme disease is an infection caused byBorrelia burgdorferi sensu lato, which is transmitted to humans through the bite of an infected Ixodes tick. The majority of patients recover without complications with antibiotic therapy. However, for a minority of patients, accompanying non-specific symptoms can persist for months following completion of therapy. The constellation of symptoms such as fatigue, cognitive dysfunction, and musculoskeletal pain that persist beyond 6 months and are associated with disability have been termed post-treatment Lyme disease syndrome (PTLDS), a subset of a broader term “chron...
Conclusions While public health efforts often focus on MSM, non-MSM with STIs is also a subgroup at high risk of incident HIV diagnosis. Non-MSM and MSM with any STI, particularly syphilis, should be prioritized for HIV testing and prevention interventions.
Conclusions Testing costs varied between venues, reflecting differences in the models used and intensity of services provided. Although staff costs are the major driver, buildings and supplies costs are also significant. Our findings suggest that outreach screenings using rapid syphilis tests may be a feasible and cost-effective tool for health departments when targeting known high-prevalence areas and hard-to-reach populations.
We present findings from the nationally representative Zimbabwe Population–based HIV Impact Assessment that characterize Zimbabwe's progress toward the Joint United Nations Programme on HIV/AIDS 90-90-90 targets. Design: We conducted a cross-sectional household survey. Methods: Consenting adults and children in the household were eligible to participate in Zimbabwe Population–based HIV Impact Assessment (October 2015–August 2016). Participants completed face-to-face interviews and provided blood for HIV, CD4, viral load, and syphilis testing. Viral load suppression (VLS) was defined as HIV RNA
Intern Med. 2021 Oct 19. doi: 10.2169/internalmedicine.8269-21. Online ahead of print.ABSTRACTWe herein report a 46-year-old man presenting with locked-in syndrome secondary to meningovascular syphilis. Brain magnetic resonance imaging (MRI) demonstrated multiple acute infarctions in the left ventromedial pons, right basis pontis, and left basal ganglia. His locked-in syndrome was hypothesized to have been caused by thrombosis of the small paramedian branches of the basilar artery due to syphilitic arteritis. This is a unique case of bilateral ventromedial pontine infarction caused by meningovascular syphilis that presente...
Conclusions: The prevalence of gestational syphilis in Cali during 2018 exceeded the national rate with a higher frequency among women in socioeconomic vulnerability conditions consistent with the general spatial distribution. There was a lack of opportunity in the early detection and management of the infection both among pregnant women and their contacts, which hinders the control of the disease and reflects the inadequate application of the comprehensive maternal and perinatal health care route guidelines.PMID:34669285 | DOI:10.7705/biomedica.6003
ConclusionsWe observe a slight increase in chlamydia and gonorrhoea incidence in the Belgian population over the study period. MSM are at higher risk of STI and represent an overwhelming proportion of syphilis cases. Being a woman is associated with higher risk of acquiring chlamydia and herpes infection. We recommend continuing prevention and awareness campaigns targeting high risk groups.Key messagesMSM and women remain high-risk populations regarding STIs among the patient population of general practitioners.Continuous STI surveillance is necessary to monitor STI related healthcare needs and adapt prevention programs.
We report an imported case of Bannwarth syndrome in a pediatric patient and review the literature for other pediatric cases reported.
Conclusions: Operative management of pediatric patients with Lyme arthritis is associated with increased resource utilization and costs while being similarly efficacious to nonoperative management. As the US Lyme epidemic expands, improved diagnosis and management of acute undifferentiated arthritis may prevent unneeded operative intervention. Level of Evidence: Level III—retrospective cohort study.