Scrotal ultrasound in male infertility.

During an 18-month period, 200 male infertility patients had scrotal sonography examination. Fifty-seven percent showed abnormal sonogram; such as epididymitis, epididymo-orchitis, orchitis, varicocele, spermatocele, epididymal cyst and undescended testis. Among all lesions, infection was the commonest finding. There was no obvious relation between oligospermic and azospermic patients with scrotal sonographic findings except for testicular atrophy, which was very common among azospermic patients. This study indicates the role of scrotal sonography in male infertility patients.

Papillon-Lefevre syndrome. A report of six cases in one family.

Papillon-Lefevre syndrome in six Saudi children in the same family is described. The parents were unaffected, and parental consanguinity was present. Palmoplantar keratosis started at the age of 1 1/2 years. The loss of deciduous teeth was a consequence of juvenile periodontitis. All essential features of the syndrome were present in this series.

Conjunctivitis caused by beta-lactamase-producing Neisseria gonorrhoeae.

Unilateral conjunctivitis caused by penicillinase-producing Neisseria gonorrhoeae was diagnosed in a 21-year-old man. The conjunctivitis apparently resulted from autoinfection from the urethral discharge. The patient was satisfactorily treated with a single dose intramuscular of cefoxitin (2 g) and oral probenecid (1 g).

An unusual presentation of histiocytosis X.

A 20-year-old, single Saudi man was examined in the outpatient clinic in January 1980, complaining of ulcers in the groin, discharge from the right ear, and gum enlargement of 2 years' duration. Also in 1980, ulcerating lesions developed in both axillae. One year later the patient was admitted to the hospital for spontaneous pneumothorax, and in the same year a small nodule in the upper left eyelid and fissuring of the nails were noted. In 1982, the patient complained of perianal ulceration and rapidly enlarging submandibular swelling with multiple sinuses and ranula.

Urethritis caused by group B streptococci: a case report.

We describe a case of urethritis caused by group B streptococci. The diagnosis was confirmed by examination of a Gram stained smear, isolation of the organism from the urethral discharge, and also by the clinical response to treatment with phenoxymethyl penicillin.

Combination therapy of sodium stibogluconate and rifampin in cutaneous leishmaniasis.

Thirty-two patients having cutaneous leishmaniasis were divided into two groups: 16 were treated with sodium stibogluconate 600 mg intramuscularly daily for 12 days and 16 were treated with 600 mg rifampin daily for 21 days. The failure rate was 56% and 50%, respectively. The 17 patients who did not respond were treated with a combination of the two drugs, which produced better results in 13 of the 17 patients.

Urethritis associated with Haemophilus parainfluenzae: a case report.

Haemophilus parainfluenzae was isolated from the urethral discharge of a man with urethritis. The patient responded favorably to treatment with amoxicillin. Although the facts suggest that this case of urethritis may have been caused by H. parainfluenzae, a possible etiologic role of other microorganisms is not ruled out.

Unusual location of syphilitic alopecia: a case report.

A case of syphilitic alopecia on the legs of young man is described. Both positive serologic tests and the clinical response to treatment with penicillin suggest that this alopecia was due to syphilis. This report suggests that the physician should be aware of the possible unusual location of syphilitic alopecia at sites other than the scalp, eyebrows, and beard.

Post-gonococcal cervicitis and post-gonococcal urethritis. A study of their epidemiological correlation and the role of Chlamydia trachomatis in their aetiology.

In a study of 157 men and 141 women with gonorrhoea post-gonococcal urethritis (PGU) in men was significantly more common among chlamydia-positive (76%) than among chlamydia-negative (22.5%) patients. Clinical investigations of PGU detected 95% of the patients infected with C trachomatis. PGU was, however, asymptomatic in over half of the patients and a careful follow-up for 3-6 weeks was necessary to detect between 80% and over 90% of cases. PGU was not related to age, past history of gonorrhoea or non-gonococcal urethritis, severity of gonococcal infection, or chlamydial inclusion count. Although post-gonococcal cervicitis (PGC) in women was an identifiable entity, it was detected in only one-third of chlamydia-positive patients. PGC was significantly associated with the 20-29 year-old age group but was not related to symptoms or chlamydial inclusion count. In the absence of facilities for culturing chlamydia, selection on an epidemiological basis of all female consorts of men with PGU, together with the remaining women with PGC, would have resulted in some unnecessary treatments and left untreated up to 30% of those harbouring C trachomatis.

Sexually transmitted diseases in Riyadh, Saudi Arabia. A study of patients attending a teaching hospital clinic.

Of 716 men attending consecutively a dermatovenereological clinic in Riyadh, Saudi Arabia, over a period of a year 70·1% had non-specific genital infection, a figure which is four times that for gonorrhoea and 13 times that for syphilis. Most of the patients were single men aged between 20 and 29 years and had acquired their infections abroad. Although Riyadh is a cosmopolitan city with a large foreign population 79% of the infections occurred in local inhabitants.

Penicillinase-producing Neisseria gonorrhoeae in Riyadh, Saudi Arabia.

Of 83 strains of Neisseria gonorrhoeae isolated in Riyadh, Saudi Arabia, between April 1979 and August 1980, 10 produced beta-lactamase and had minimum inhibitory concentrations (MICs) of penicillin between 1 and greater than or equal to 4 micrograms/ml. Of the 73 (88%) non-penicillinase-producing strains, 55% had diminished sensitivity to penicillin (MIC = 0.06 micrograms/ml) and 11 (15%) were highly resistant (MICs ranging from 0.5-2 micrograms/ml). This high incidence of resistance may be due to widespread abuse of antibiotics; it also confirms that two mechanisms of resistance to penicillin exist in this species.

Urethritis due to Schistosoma haematobium with superimposed gonorrhea.

A case of urethritis due to Schistosoma haematobium with superimposed gonorrhea is described. The diagnosis was confirmed by the presence of gram-negative intracellular diplococci in the urethral discharge and of characteristic terminal spined Schistosoma haematobium ova in the urine, as well as by the favorable clinical response to treatment with the antischistosomal drug niridazole. A diagnosis of schistosomiasis should be considered for patients in whom treatment with drugs that are active against the common causes of urethritis fails, particularly when such patients live in an area where bilharzia is endemic or epidemic.

Liver involvement in secondary syphilis.

The results of biochemical assessment of liver function are reported in 18 patients with secondary syphilis. In 9 of the patients, enzyme abnormalities were found and the most consistant abnormality was an elevated alkaline phosphatase. Six of the patients had a liver biopsy before treatment and the main findings were mononuclear cell infiltration around the central veins and portal tracts. In all patients, the biochemical abnormality returned to normal with treatment of the syphilis.