Co-infecção de sífilis e papilomavívus humano: interrompendo uma cadeia de transmissão vertical / Co-infecção between syphilis and human papilomavirus: broken a vertical transmission chain

Um paciente do sexo masculino, 26 anos, branco, casado, com o nível de escolaridade fundamental, residente no município de Duque de Caxias, Rio de Janeiro, foi atendido no Ambulatório do Instituto de Dermatologia Rubem David Azulay na Santa Casa de Misericórdia do Rio de Janeiro, em março de 2005, com queixa inicial de “verruga” peniana clássica, sugestiva, pela avaliação clínica, de um caso de HPV. Foi solicitada então como exame complementar a testagem sorológica para sífilis, aconselhada a realização do exame para detecção de anticorpos para o vírus HIV e foi sugerido também que ele trouxesse a sua parceira sexual para avaliação clínica. A realização do teste não treponêmico de sífilis, o VDRL (Veneral Disease Research Laboratory), foi reator 1:16, sendo confirmado pelo teste treponêmico TPHA (Treponema pallidum Hemaglutination Assay). O paciente não voltou para a consulta agendada, só retornando, cinco meses depois, acompanhado da esposa grávida de cinco meses. Ambos foram tratados de acordo com os protocolos do Ministério da Saúde. Na análise desse caso foram evidenciadas várias facetas das co-infecções das doenças sexualmente transmissíveis (DST).

A patient, male, 26 years old, married, with elementary school ship, lived in Duque de Caxias, Rio de Janeiro, Brazil, came for the clinical of Sexually Transmited Disease (STD) in Rubem David Azulay Dermatology Institute in Santa Casa de Misericórdia, Rio de Janeiro, with the principal complaint of a wart in his penis. After the first clinical evaluation, it was concluded that it was a case of human papilomavirus, the HPV. He was solicited complementary exams to detect syphilis and he was advised to make a test to detect antibody for HIV, he was also suggested that it was important to bring his wife in the next consult for evaluation. When the syphilis test of VDRL (Veneral Disease Research Laboratory) was realized it was detected a title of 1:16, it was confirmed with T.P.H.A.( Treponema pallidum Hemaglutination Assay), a treponema test. Unfortunately the patient didn’t come in the following consult, only regressing five months later. In this occasion he brought his wife, she was five months of pregnancy. Both of them was treated in accord of the protocol of the Health Ministry. In this Case of Study it was evidenced the relationship of co-infection in the sexually transmitted disease (STD).