Coexistence of multiple sexually transmitted infections in a human immunodeficiency virus-negative individual

Abstract

Sexually transmitted infections (STIs) are a major public health problem for men and women worldwide as they cause acute disease as well as a long-term complications, if left untreated. We report a young migrant laborer with high-risk, sexual behavior who presented with asymptomatic, warty papules of penile shaft of 3 months duration, multiple asymptomatic penile ulcers of 10 days, and yellowish creamy discharge per urethra of 1 week duration. Clinical evaluation and investigations confirmed the diagnosis of coexisting primary syphilis (chancre), acute gonococcal urethritis, genital wart, and hepatitis C virus (HCV) infection. Serology for human immunodeficiency virus (HIV) infection was negative. He was treated with doxycycline 100 mg twice a day per orally for 14 days (for primary syphilis), ceftriaxone 250 mg single-dose intramuscularly (for gonococcal urethritis), azithromycin 1 g single dose per orally and topical 25% podophyllin in tincture benzoin (applied by the clinician for genital wart). He was referred to the department of general medicine for further evaluation and management in view of the positive serology for anti-HCV antibodies. We report this case to highlight the rare coexistence of multiple STIs in an HIV-negative patient.