Myiasis is a parasitic infestation caused by the larvae of several fly species. Diagnosis and treatment are simple. The
location of this infestation at the vulvar area is, however, an extremely rare occurrence. The authors present two
cases of vulvar myiasis affecting pregnantwomen. The first case is a 19-year-old pregnant girl with vulvar myiasis and
concomitant syphilis, vaginal trichomoniasis and genital candidiasis. The patient was also HIV-positive. The second
case is a 17-year-old pregnant girl with vulvar myiasis associated with extensive vulvar condyloma acuminatum
lesions.

Mauro R. L. Passos

Renata Q. Varella

Rog&#233;rio R. Tavares

Nero A. Barreto

Cl&#225;udio C. C. Santos

Vandira M. S. Pinheiro

Renato S. Bravo

Maur&#237;cio H. L. Morelhi

Vulvar Myiasis During Pregnancy

Objective: To assess differences in prevalence and cell densities of enterococci, Gram negative enterics (GNEs),
yeast and Staphylococcus aureus among four genital sites and to examine whether the presence of organisms at one
site affected the presence of organisms at other sites.Methods: Swab samples from the perineum, below and above the hymen, and the posterior fornix obtained
from 52 tampon users on menstrual cycle day 3 were analyzed for site-specific prevalence and cell densities of
microorganisms.Results: Enterococci and GNEs were the most prevalent study organisms at all sites and decreased in prevalence
fromthe perineumto the posterior fornix.Cell densities similarly decreased frombelow the hymen to the posterior
fornix. Yeast were detected at the hymen only; S. aureus frequency was similarly low at all sites. Yeast and S. aureus
site-specific cell densities were similar. The above- and below-hymen sites were similar in prevalence and cell
density of organisms. An above-chance association existed between the presence of any study organism below
the hymen and above the hymen and was strongest for GNEs.Conclusions: The pattern of genital colonization with enterococci and GNEs reflects their likely gastrointestinal
source. The absence of significant differences in the prevalence and cell densities of study microflora above and
below the hymen combined with an above-chance association of the presence of microorganisms at these regions
suggests that the regions above and below the hymen are not different with respect to the presence of the
organisms evaluated in this study.

Anne E. Hochwalt

Ronald W. Berg

Sandy J. Meyer

Rachelle  Eusebio

Site-Specific Prevalence and Cell Densities of Selected Microbes
in the Lower Reproductive Tract of Menstruating Tampon Users

Objective: Bacterial vaginosis (BV) is a known risk factor for postoperative infection following abdominal hysterectomy.
Vaginal bacterial flora scored as intermediate has been shown to have the same risk of postoperative
infection as BV.Methods: Women undergoing total abdominal hysterectomy for benign diseases were open-randomized according
to Zelen to either treatmentwith metronidazole rectally for at least 4 days or no treatment. At the preoperative
gynecological examination a vaginal smear was collected and Gram stained. Women with BV or intermediate flora
were merged to one group called abnormal vaginal flora.Results: In total 213 women were randomized to treatment or no treatment. After exclusion of 71 women, 142
women were eligible for analysis. Among the 59 women diagnosed with abnormal vaginal flora there were no
vaginal cuff infections in the treated arm, comparedwith 27% in the ‘no treatment’ arm (p &lt;0.01). Treatment also
reduced the vaginal cuff infection rate from 9.5 to 2% among the 83 women with lactobacilli flora. However,
this difference was not statistically significant. Treatment had no effect on the rate of wound infections.
Intention-to-treat analysis showed a significant reduction in vaginal cuff infections among women randomized
to treatment.Conclusion: Pre- and postoperative treatment for at least 4 days with metronidazole rectally reduces
significantly vaginal cuff infection among women with abnormal vaginal flora.

Per-Göran Larsson

Bodil Carlsson

Does Pre- and Postoperative Metronidazole Treatment Lower
Vaginal Cuff Infection Rate After Abdominal Hysterectomy
Among Women With Bacterial Vaginosis?

Objectives: To determine the risk of perinatal transmission of hepatitis B virus (HBV) in Jordan.Methods: Plasma samples from 1000 pregnant Jordanian women were screened by ELISA for HBV markers
(HBsAg, HBeAg, anti-HBe, anti-HBc and anti-HBs).Results: HBsAg and HBeAg were detected in 4.3% and 0.1% of the pregnant women, respectively. The overall
prevalence of antibodies was 6%, 11.1% and 7.5% for anti-HBe, anti-HBc and anti-HBs, respectively. Women
were assignedto four groups according to the serological patternsofHBV markers: susceptible (85.9%), with acute
infection (2.9%), with chronic infection (1.4%) and previously infected (9.8%). Most women were at the third
trimester of pregnancy, therefore women with acute and chronic hepatitis at this gestational age were at risk of
transmitting HBV infection to their newborns. Women who belonged to the low socio-economic class were
at higher risk of HBV infection.Conclusions: Based on the results, we recommend screening women for HBV during pregnancy in order to
identify HBV carriers. All newborns born to carriers should be vaccinated immediately after birth, both passively
and actively. Also vaccination of HBV seronegative pregnant women is recommended.

Naji Batayneh

Salwa Bdour

Risk of Perinatal Transmission of Hepatitis B Virus in Jordan

Objective: To evaluate the antimicrobial susceptibility of Gram-negative uropathogens isolated from pregnant
women.Methods: We performed a snapshot cohort study of women receiving care in the University of Florida prenatal
clinics duringMarch 2000. Subjects with asymptomatic bacteriuria or cystitis were identified and the antimicrobial
susceptibility of each pathogen was recorded. Data were analyzed using chi-square, Fisher&#39;s exact test and
ninety-five percent confidence intervals, as appropriate.Results: Ninety-five positive cultures were identified. Isolates were more often susceptible to trimethoprimsulfamethoxazole
(TMP-SMX) (87&#37;) and nitrofurantoin (89&#37;) than to ampicillin (72&#37;) (p &#60; 0.03). Escherichia coli
accounted for 71 (75&#37;) cases and was more often susceptible to nitrofurantoin (100&#37;) than to TMP-SMX (87&#37;)
(p &#60; 0.01). Proteus isolates were all susceptible to TMP-SMX and resistant to nitrofurantoin (p &#60; 0.01).Conclusions: Both TMP-SMX and nitrofurantoin are superior to ampicillin for empiric treatment of lower urinary
tract infection in pregnant women. Nitrofurantoin is superior to TMP-SMX for treatment of infections caused by
E. coli. For suspected or confirmed cases caused by Proteus organisms, TMP-SMX is the preferred agent.

Whitney E. Jamie

Rodney K. Edwards

Patrick  Duff

Antimicrobial Susceptibility of Gram-Negative Uropathogens
Isolated From Obstetric Patients

Sebastian Faro

A Tribute to Abe Mickal, 1912&#x2013;2001

About this journal

Infectious Diseases in Obstetrics and Gynecology publishes articles related to infectious diseases in women’s health. Topics include diagnosis and treatment of sexually transmitted diseases, urinary tract infections, and infections in pregnancy.

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Infectious Diseases in Obstetrics and Gynecology - Table of contents 2002

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Infectious Diseases in Obstetrics and Gynecology publishes articles related to infectious diseases in women’s health. Topics include diagnosis and treatment of sexually transmitted diseases, urinary tract infections, and infections in pregnancy.

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Infectious Diseases in Obstetrics and Gynecology

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Infectious Diseases in Obstetrics and Gynecology

Table of Contents

Table of Contents: 2002

Vulvar Myiasis During Pregnancy

Site-Specific Prevalence and Cell Densities of Selected Microbes in the Lower Reproductive Tract of Menstruating Tampon Users

Does Pre- and Postoperative Metronidazole Treatment Lower Vaginal Cuff Infection Rate After Abdominal Hysterectomy Among Women With Bacterial Vaginosis?

Risk of Perinatal Transmission of Hepatitis B Virus in Jordan

Antimicrobial Susceptibility of Gram-Negative Uropathogens Isolated From Obstetric Patients

A Tribute to Abe Mickal, 1912–2001