Constellation of multiple sexually transmitted infections in promiscuous individuals

Abstract

A middle-aged promiscuous male presented with multiple painful ulcers over the genitals for the past 2 weeks. Basic side lab procedures were done. Gram stain showed Gram-negative coccobacilli in a school of fish pattern. Tzanck smear revealed acantholytic cells and multinucleated giant cells. On KOH examination from the subpreputial discharge, there were numerous pseudophyphae and spores. Based on the clinical grounds and the laboratory evidence, mixed sexually transmitted infection was diagnosed. Another case presented with painful ulcers and tiny papules over the perianal region. After all bedside and serological investigations, he was diagnosed with herpes genetalis, condyloma late, condyloma acuminata, and Human Immunodeficiency Virus 1 positive.