HPV was detected on at least one vibrator immediately after use in the women with vaginal HPV. This supports the potential for HPV transmission via shared sex toy use, and is additionally supported by continued detection of HPV up to 24 h after standard cleaning. The data add to understanding of the range of sexual behaviours associated with HPV transmission, and the need for evidence-based recommendations for sex toy cleaning.

Whipple's disease is a rare cause of chronic diarrhea and abdominal pain that may be confused with inflammatory bowel disease. We report a Whipple's case misdiagnosed as Crohn's disease in which treatment with anti-tumor necrosis factor (anti-TNF) therapy led to nearly fatal progression. Lymph node tissue obtained during laparotomy for suspected bowel necrosis stained dramatically with periodic acid–Schiff (PAS), and electron microscopy showed a bacterium consistent with Trophyrema whipplei. The patient made a remarkable recovery complicated only by cholestatic hepatitis, which was likely a treatment-associated inflammatory response. This case serves as a reminder that all granulomatous infections should be considered prior to initiation of anti-TNF therapies.

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Objetives To determine the prevalence and aetiology of lower genital tract infections (LGTIs) in symptomatic women of reproductive age and describe the risk factors. Methods Cross sectional study. Symptomatic women who consulted at three ambulatory care centres in Bogotá, Colombia. Exclusions: pregnancy, hysterectomy, antibiotics in the previous 7 days. Samples were obtained for etiologic diagnosis using gold standard tests for: bacterial vaginosis (VB) by Nugent's criteria; blood agar culture for Candida and a wet smear and In pouch™ culture for T. vaginalis. PCR for C. trachomatis (CT) and N. gonorroheae (NG), and serologic tests for syphilis (RPR, TPHA) and HIV. Results 1385 women were recruited from February to December 2010. 115 (8.3%) of them were sexual workers. A LGTI was confirmed in 731 (52.7%); 560 (40.4%) had an endogenous infection and 170 (12.3%) a sexually transmitted infection (STI). The most frequent aetiology was VB in 549 (39.6%), followed by candidiasis in 153 (11%). CT was detected in 134 (9.7%), NG in 19 (1.4%), Trichomonas by wet smear in 11 (0.8%) and by culture in 8/634 (1.2%), syphilis in 12 (0.8%) and HIV in 1 case. The risk factors of STI are: sex workers (OR: 2.0, CI 95% 1.2 -3.3), younger age (28 ± 7.8 vs. 32 ± 8.9 (mean ± SD), no health insurance (23.5 vs. 15.4%) and alcohol users (OR: 2.6 (95% CI: 1.4 -4.5)) Conclusions: 52.7% of women who consult for symptoms of LGTIs an aetiology can be identified, being BV the most common and Chlamydia the most frequent STI. Almost the same number of women (47.3%) has no specific aetiology identified, even with the use of gold standard diagnostic technology. This information should be used by policy makers and clinicians for prioritisation of prevention and diagnosis of LGTIs and use of syndromic management Background Recommendations for the frequency of STI screening in high-risk populations are limited by lack of data about when infections occur following a negative screening test. Methods Participants (18-29 years of age; women [N = 192] and men [N = 156]) in a 12-week study of incident STI were recruited from a county STI clinic. Self-collected vaginal samples (women) and urine samples (men) were obtained weekly at participant's home. Nucleic acid amplification tests (NAAT) were used for diagnosis of C. trachomatis, N. gonorrhoeae, and T. vaginalis infections. Infections diagnosed at enrollment were treated immediately. Based on cumulative diary reports of partner-specific sexual behaviours, an exposure variable was created to indicate vaginal exposure with only one partner, or with more than one partner. Time to infection was modelled using Kaplan-Meier curves; group differences were

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