Brazilian Journal of Sexually Transmitted Diseases https://bjstd.org/revista Sociedade Brasileira de Doenças Sexualmente Transmissíveis en-US Brazilian Journal of Sexually Transmitted Diseases 2177-8264 The genital tract microbiome: bridging the gap between hype and clinical reality https://bjstd.org/revista/article/view/1396 <p>In the last years there has been a huge interest in the study of the human microbiome, and the genital tract one has been no exception. However, we still fail to fully understand the normal and abnormal genital tract microbiome. Despite the increasing knowledge, the diagnosis of vaginitis is mostly empirical and many interventions, such as the use of probiotics, are not supported by good quality evidence.</p> Pedro Vieira-Baptista Copyright (c) 2023 Brazilian Journal of Sexually Transmitted Diseases https://creativecommons.org/licenses/by/4.0 2024-01-09 2024-01-09 36 10.5327/DST-2177-8264-2024361396 Giant chancre in an octogenary patient. Always remember syphilis! https://bjstd.org/revista/article/view/1386 <p><strong>Introduction</strong><strong>:</strong> Syphilis is a sexually transmitted infection (STI) caused by the <em>Treponema pallidum </em>and has become epidemic in the past two decades. The disease is often asymptomatic, and its manifestations are diverse. It may affect multiple systems, posing the risk of serious consequences or even death. <strong>Objective</strong><strong>:</strong> To present a case of an exuberant syphilis-related lesion in an elderly man. <strong>Case report</strong><strong>:</strong> An 85-year-old man presented with a painless penile lesion. He reported having had oral sexual contact (felatio) with a female sex worker six weeks prior the presentation of the lesion. During the physical exam, an ulcer measuring three to four cm was observed, reaching subcutaneous tissue down to the Buck’s fascia, and presenting a clean beefy red base, and an infiltrated edge. Bilateral and movable enlarged and painless lymph nodes were found. The rapid immunochromatographic test was positive for syphilis and negative for HIV, hepatitis B, and hepatitis C. Treatment consisted of an <em>in loco</em> injection of 2,400,000 IU of benzathine penicillin. <strong>Conclusion</strong><strong>:</strong> In spite of being more common among younger individuals, syphilis should be always considered in the differential diagnosis of genital ulcers, regardless of the patient's age. Many aged people keep an active sexual life especially with the increase of longevity and effective therapeutic measures for erectile disfunction. The false belief that sexual activity ceases to exist in older age groups must, therefore, be abandoned.</p> Mauro Cunha Ramos Andressa Goldman Ruwel Copyright (c) 2024 Brazilian Journal of Sexually Transmitted Diseases https://creativecommons.org/licenses/by/4.0 2024-02-28 2024-02-28 36 10.5327/DST-2177-8264-2023351386