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Genital tract parasitic infestations are extremely rare, particularly during pregnancy. Awareness of such cases is crucial for accurate diagnosis and management. A 22-week pregnant woman in the 20s presented with lower abdominal pain. The general examination was normal; however, speculum examination revealed worm infestation of the uterine cervix with cervical ectropion. Microscopic examination of the cervical smear identified a gravid female Enterobius vermicularis containing eggs. The patient was treated with albendazole (400 mg, repeated after 2 weeks), and household contacts received the same treatment. The patient had a full-term vaginal delivery with no maternal or neonatal complications. No recurrence of symptoms was reported postpartum. This case highlights E. vermicularis infestation of the uterine cervix as a rare cause of abdominal pain during pregnancy. Clinicians should consider parasitic infections in the differential diagnosis of cervical lesions or unexplained pain, especially in endemic regions.

Interferon-based local therapy is an intervention for high-risk human papillomavirus (HR-HPV)-associated low-grade squamous intraepithelial lesions (LSIL) or lower-grade cervical abnormalities. This study sought to delineate the differences in clinical outcomes following interferon-based local drug treatment and elucidate the microenvironmental factors driving these disparities. Cervical secretions, cell brush specimens, and cervical tissue samples were collected from patients with persistent HR-HPV infection and LSIL/lower-grade lesions at Shanghai First Maternity and Infant Hospital. Follow-up samples were obtained at 3 months post-treatment. Cervical secretions were subjected to 16S rRNA sequencing (to profile the microbiota) and cytokine quantification. Cell brush specimens were analyzed via transcriptome sequencing, while cervical tissue samples underwent immunohistochemical staining. Efficacy-related markers were assessed through both inter-group (independent comparisons) and intra-patient (self-paired) analyses. At the transcriptome level, the HR-HPV clearance group exhibited lower enrichment in pathways related to differentiation, keratinization, and development but higher enrichment in immune activation pathways compared to the persistence group at baseline (with a reversed pattern observed at follow-up). Baseline expression of , and was higher in the clearance group, and expression remained consistently elevated. Immunohistochemical findings further demonstrated that the percentage of TRAF3IP3- and ZBP1-positive cells at baseline was significantly higher in the clearance group than in the persistence group. At the microbial level, treatment failure was associated with reduced abundance, increased , , , and abundance, alongside higher alpha diversity. Among cervical secretory cytokines, IL-2, IL-8, IL-12p70 showed inter-group differences, while IL-4 and IL-5 were barely detectable. This study characterizes the cervical microenvironmental differences underlying divergent responses to interferon-based therapy, highlighting that coordinated changes in the microenvironment and immune status modulate treatment outcomes. The upregulated mRNA and protein levels of TRAF3IP3 and ZBP1 in the baseline period favor HR-HPV clearance, suggesting their potential as promising therapeutic targets.

Background: Conventional therapies for human papillomavirus (HPV) infection are often associated with unsatisfactory response rates and high recurrence rates. The use of a systemic agent may more effectively control the virus. Objectives: To investigate the efficacy and safety of low dose oral isotretinoin in recalcitrant condylomata acuminata (RCA) of the cervix. Methods: Double blind placebo controlled clinical trial. 60 women, aged 21–43 years, with RCA of the cervix, refractory to at least one conventional therapy, were randomly assigned to receive either isotretinoin, 0.5 mg/kg daily for 12 weeks (group 1), or placebo (group 2). Results: Of the 28 evaluable group 1 patients, nine (32.1%) responded to the treatment completely, 11 (39.2%) responded partially, and eight (28.5%) did not respond. Of the 25 group 2 patients, no one responded to the treatment completely, two (8%) responded partially, and 23 (92%) did not respond. The therapeutic difference between patients receiving active and placebo therapy was statistically significant (χ2 = 19.35, p<0.001). Only one (11.1%) of the complete responders experienced recurrence during the 12 month follow up. Side effects were generally mild and resolved upon completion of therapy. Conclusions: Compared to placebo, low dose oral isotretinoin showed considerable efficacy with insignificant and reversible side effects and a low recurrence rate. Isotretinoin may represent an efficacious and safe alternative systemic form of therapy for RCA of the cervix.

Introduction The objectives of this study were to estimate the economic burden of HPV in Italy, accounting for total direct medical costs associated with nine major HPV-related diseases, and to provide a measure of the burden attributable to HPV 6, 11, 16, 18, 31, 33, 45, 52, 58 infections. Methods A cost-of-illness incidence-based model was developed to estimate the incidences and costs of invasive cervical cancer, cervical dysplasia, cancer of the vulva, vagina, anus, penis, oropharyngeal, anogenital warts, and recurrent respiratory papillomatosis (RRP) in the context of the Italian National Health System (NHS). We used data from hospital discharge records (HDRs) of an Italian region and conducted a systematic literature review to estimate the lifetime cost per case, the number of incident cases, the prevalence of HPV9 types. Costs of therapeutic options not included in the diagnosis-related group (DRG) tariffs were estimated through a scenario analysis. Results In 2018, the total annual direct costs were €542.7 million, with a range of €346.7–€782.0 million. These costs could increase considering innovative therapies for cancer treatment (range 16.2-37.5 million). The fraction attributable to the HPV9 genotypes without innovative cancers treatment was €329.5 million, accounting for 61% of the total annual burden of HPV-related diseases in Italy. Of this amount, €135.9 million (41%) was related to men, accounting for 64% of the costs associated with non-cervical conditions. Conclusions The infections by HPV9 strains and the economic burden of non-cervical HPV-related diseases in men were found to be the main drivers of direct costs.

To determine the effect of highly active antiretroviral therapy (HAART) on high-risk human papillomavirus (HR-HPV) infections and related cervical lesions, the virologic and cytologic markers of HPV infection were prospectively studied in 163 human immunodeficiency virus (HIV)–infected women, including 27 untreated, 62 treated with reverse transcriptase inhibitors, and 74 treated with HAART. A high prevalence of both infections with HR-HPV types (68%) and squamous intraepithelial lesions (SILs; low grade, 20.2%; high grade, 6.2%) was observed. The risks of infection and disease were inversely correlated with CD4 cell counts (P=.015 and P=.022, respectively). During the observation period (mean, 15.4 months; range, 6–24 months), CD4 cell counts increased significantly only in subjects receiving HAART (P<.001). Persistence of HR-HPV infection and progression of SILs were comparable in the 3 groups. These results indicate that, even in the era of HAART, HIV-infected women should be monitored carefully for the emergence of high-grade SILs and cervical cancer

•A patient self-selected two group comparison study was performed.•Efficacy of Badushengjigao for treating symptomatic cervical ectopy was evaluated.•Badushengjigao seemed to be more effective than policresulen suppository.•Badushengjigao had less adverse effects than policresulen suppository. The aim of this study is to evaluate the treatment and efficacy of Badushengjigao, a traditional Chinese medicine (TCM) formula, for symptomatic cervical ectopy. A patient self-selected two group comparison study was performed. One hundred patients with symptomatic cervical ectopy admitted to the Central Hospital of E-Zhou (Hubei, China) between July 2013 and July 2014 were enrolled in the study. The patients treated with Badushengjigao were the study group and the patients treated with policresulen suppository were the control group. The medicine was administered through vagina. Patients received a three-month follow-up (once a month). The treatment results were evaluated and analyzed by variance analysis and X2 test. The curative rates of the two groups with symptomatic cervical ectopy grade 1 shows no statistical significance. As for grade 2 and grade 3, the curative rates of the study group (phase 2: 72.0%; phase 3: 62.5%) are higher than that of the control group (phase 2: 44.4%; grade 3: 54.5%) with statistical difference (P<0.05). The study group has less adverse effects (2.5±1.3 days of vagina bleeding, 6 cases of abdominal pain and 2 cases of increased discharge) than the control group (12.5±1.1 days of vagina bleeding, 15 cases of abdominal pain and 42 cases of increased discharge) with distinctive statistical difference (P<0.01). The TCM formula, Badushengjigao, seems to be more effective than policresulen suppositories in treating symptomatic cervical ectopy phase 2 and phase 3. We suggest that it could be used as an alternative method for symptomatic cervical ectopy treatment, but further study is needed.

Tuberculosis (TB) is still frequently observed in third-world countries like Africa and Asia. Here we report three cases of genital TB with variable presentation. First case was a lady of reproductive age group who presented with polymenorrhagia and postcoital bleeding with unhealthy cervix. Histopathology of cervical tissue revealed tubercular cervicitis. Second and third cases presented with different complaints like discharge per vaginum, postcoital bleeding and pain in lower abdomen with growth over the cervix. Cervical biopsy was inconclusive of TB but endometrial tissue sampling for TB PCR was positive. This shows that newer diagnostic marker test can help us to detect secondary genital TB.

Background and Objectives: Due to the steadily progressive development of resistance to the drugs used for treatment, Neisseria gonorrhoeae remains a medical concern. Trospectomycin sulfate is a 6' propyl analogue of spectinomycin with potent activity against penicillin sensitive and resistant strains of N. gonorrhoeae. Goal of this Study: To compare the efficacy of 250 mg trospectomycin sulfate IM versus 250 mg ceftriaxone IM for single dose therapy for men and women with uncomplicated gonorrhea. Study Design: Dual-center, randomized comparative trial. Results: Among evaluable male patients with urethral gonorrhea, 36 of 40 (90%, 95% confidence interval [95%CI] 76%97%) who were treated with trospectomycin sulfate were cured, and 22 of 22 patients (100%, [85%-100%]) treated with ceftriaxone were cured. Among evaluable female patients with cervical gonorrhea all were cured following trospectomycin sulfate (23 of 23) and following ceftriaxone therapy (13 of 13). The cure rates for pharyngeal gonorrhea were 67% (8 of 12 patients, 35%-90%) for trospectomycin sulfate therapy, and 100% (2 of 2) with ceftriaxone therapy. Conclusions: Trospectomycin sulfate, 250 mg IM, is effective, and well tolerated. However, for treatment of uncomplicated genital and pharyngeal gonorrhea, it is not as reliable for therapy as other recommended regimens.