Sexually transmitted penile amoebiasis in Iran: a case series
- Alireza Abdolrasouli1,2,3,
- Henry J C de Vries4,5,6,7,
- Yahya Hemmati3,
- Azita Roushan3,
- Jason Hart1,
- Michael Anthony Waugh8
- 1Department of Medical Microbiology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
- 2Department of Infectious Diseases and Immunity, Medical School, Hammersmith Campus, Imperial College London, London, UK
- 3Department of Clinical Microbiology, Marie-Curie Medical Institute, Tehran, Iran
- 4Department of Dermatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- 5STI outpatient clinic, Cluster Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands
- 6Centre for Infections and Immunity Amsterdam (CINIMA), Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- 7Centre for Infectious Disease Control, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
- 8Department of Out patients, Nuffield Hospital, Leeds, UK
- Correspondence to Alireza Abdolrasouli, Department of Medical Microbiology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, 4th Floor, East Wing, Fulham Palace Road, London W6 8RP, UK;
- Accepted 26 July 2012
- Published Online First 28 August 2012
Objectives Four cases of penile amoebiasis (PA) presenting as genital ulceration seen among men who practiced unprotected insertive anal intercourse in Tehran are described.
Methods PA was confirmed by observation of motile trophozoites of Entamoeba histolytica from lesions examined by wet mount microscopy.
Results Ulcers were solitary, painful, irregular, discharging and increasing in size. Three heterosexuals and one bisexual had practised insertive anal intercourse in the 2 weeks before diagnosis. Bilateral inguinal lymphadenitis occurred in one case. Direct examination of lesions was positive for the presence of amoebic trophozoites. Complete resolution occurred after treatment with oral metronidazole 800 mg three times daily for 7–10 days.
Conclusions Clinicians need to be aware of cutaneous amoebiasis in sexually active men who practice unprotected insertive anal sex where intestinal amoebiasis is endemic. Wet mount microscopy is a rapid and useful diagnostic test.