Subsequent STI frequently follow an initial STI, but there is substantial variation in the causal organism. These data suggest the importance of comprehensive STI prevention programs for adolescents rather than organism-specific interventions.

Infection with Sporothrix schenckii causes a localized lymphocutaneous disease in the immunocompetent host, while it frequently results in disseminated disease in the immunocompromised patient. There are a growing number of reports of S. schenckii infection in the human immunodeficiency virus (HIV)-infected population, where the disease usually starts as a localized cutaneous lesion and subsequently disseminates. The optimal treatment of systemic sporotrichosis in HIVpositive patients is as yet unknown. This article presents a case report of disseminated sporotrichosis in an HIV-infected patient, a review of the literature, and discussion of treatment options for HIVinfected patients.Sporotrichosis is caused by Sporothrix schenckii, a dimormixed superficial and perivascular inflammation compatible with an eczematous process. He responded to therapy with phic fungus with a global distribution. It is found in soil [1] and plant material such as sphagnum moss [2]. Sporotrichosis high-dose prednisone and cephalexin, but the lesions subsequently worsened. commonly presents as limited lymphocutaneous lesions but in rare cases is disseminated [3]. The lymphocutaneous form reThree months after presentation he was hospitalized with progressive disease involving an eschar on the distal thumb and sults from cutaneous inoculation and subsequent lymphatic spread. Disseminated disease may be acquired through cutaprominent woody edema of the wrist. The patient underwent debridement of the right thumb, received ceftriaxone, and was neous inoculation, inhalation, or (rarely) ingestion [3,4], and it usually results in diffuse cutaneous lesions with involvement referred to our institution for further evaluation.On presentation a biopsy of a wrist lesion was performed, of one or more additional organ systems.and high-dose prednisone therapy was given for presumed pyoDisseminated disease most freqently occurs in immunocomderma gangrenosum. One week later, there was worsening of promised individuals such as alcoholics, diabetics [5], patients the skin lesions over the forearm (figure 1) and further ulcerwith chronic obstructive pulmonary disease [5] or a hematoation and necrosis of the right thumb, with lymphatic streaking logic malignancy, solid organ or bone marrow transplant recipi-(figure 2). Periodic acid -Schiff staining and Grocott-Gomori ents, those receiving corticosteroid therapy, and those infected methenamine -silver nitrate staining of the skin biopsy speciwith HIV [5 -7]. In this report we describe a case of disseminmens revealed numerous cigar-shaped spores consistent with ated sporotrichosis and S. schenckii fungemia occurring as the S. schenckii. initial presentation of AIDS.The patient was hospitalized and received amphotericin B (0.5 mg/[kgrd]) for disseminated sporotrichosis and ticarcillin/ Case Report clavulanic acid for presumed secondary bacterial infection. He A 47-year-old male presented to our facility for evaluation subsequently tested positive for HIV and had a CD4 cell count of skin lesions. Four months ...

No abstract

Immunohistochemical assays for human papillomavirus (HPV) L1 protein, using antiserum directed against the L1 major capsid protein of bovine papillomavirus (anti-BPV serum), were performed on 101 condylomata acuminata biopsy samples from 47 men (40 of whom had intact cell mediated immunity [CMI], and 7 with conditions known to cause CMI defects), and 54 women (48 with normal CMI, and 6 with CMI defects). L1 protein was detected in 28% of all biopsies, including 20.5% of samples from patients with normal CMI and 76.9% of patients with CMI defects (P = .00002). For both males and females, L1 protein was detected significantly more often in samples from patients with CMI defects than those with normal CMI. Immunohistochemical assays of HPV 11-infected human foreskin implants grown in athymic mice were performed to optimize the conditions of the assay. Three dilutions of anti-BPV serum or preimmune rabbit serum were used. A 1:500 dilution provided readily interpretable results, while preimmune serum at this dilution did not stain to any significant degree. However, at 1:10 and 1:100 dilution, both the anti-BPV serum and preimmune serum caused an unacceptable amount of nuclear staining, making results uninterpretable. Defects in CMI may allow active viral particle assembly at an increased rate, as judged by detection of L1 protein in condylomata acuminata from these patients.