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John Hunter's work included description of the nature of digestion, child development, role of the lymphatic system and proof that the maternal and foetal blood supplies are separate. His contribution to the understanding of venereal diseases is reviewed. Hunter's argument of the unitary nature of venereal diseases is examined and the progress he made in diagnosis and management is discussed., (© The Author(s) 2014.)

In January 2012, a case of Human African Trypanosomiasis (HAT) has been identified in Germany in a traveller returning from the Masai Mara area in Kenya. The 62-year-old man had travelled to the Masai Mara game park from 18 to 19 January 2012 and developed fever on 28 January. The infection with Trypanosoma brucei rhodesiense was confirmed by laboratory testing three days hereafter.

A Belgian traveller was diagnosed with human African trypanosomiasis (HAT) due to Trypanosoma brucei rhodesiense nine days after visiting the Masai Mara area in Kenya. He presented with an inoculation chancre and was treated with suramin within four days of fever onset. Two weeks earlier, HAT was also reported in a German traveller who had visited the Masai Mara area. Because no cases have occurred in the area for over 12 years, this may indicate a focal cluster of HAT.

We present a case of early syphilis in a HIV negative bisexual man after an oral insertive intercourse with clinical overlap of primary and secondary stages, and laboratory and other criteria for syphilitic hepatitis. Moreover, we herein stress the importance of awareness of the high-risk behaviors and report syphilitic hepatitis without jaundice, a usually unrecognized clinical condition, emphasizing the clinical and therapeutic importance of its occurrence among syphilitic cases.

Objective: Syphilitic ocular manifestations are polymorphous and usually occur during the secondary or tertiary stage of syphilis. We report a case of primary syphilis revealed by papillitis., Design: A 22 year old man presented with blurred vision in the left eye and decreased visual acuity. Fundus examination and fluorescein angiography revealed a papilledema in the left eye and chorioretinitis in the right one. Clinical examination revealed a painless ulceration of the chin. Blood tests were positive for syphilis (positive reaction to the VDRL test and TPHA titer at 1/640) but negative for HIV. After penicillin therapy, the ocular manifestations resolved., Results: Papillitis is a relatively rare ocular manifestation of syphilis. Our case is original because papillitis was the presenting manifestation of the disease and that it was concomitant with the primary chancre., Conclusion: Systematic screening for syphilis should be performed in unexplained ocular inflammation.

We describe a case of a heterosexual HIV-negative man treated for primary syphilis with oral doxycycline in accordance with Clinical Effectiveness Group guidelines for treatment of early syphilis. Following an initial adequate response, he developed secondary syphilis three months later. We discuss the most likely cause of this relapse and the significance of such cases in the context of an outbreak of syphilis.

We report a 26-year-old housemaid whose partner was an intravenous drug abuser with undiagnosed pulmonary tuberculosis. The patient presented with a painless chin ulcer with an elevated irregular border and a firm, nontender submandibular adenopathy. The lesion had been present for 2 months and did not respond to antibiotic therapy. The tuberculin test was positive, and a biopsy and Löwenstein culture confirmed the diagnosis of cutaneous chancre. The patient was treated with rifampicin, isoniazid and pyrazinamide and, after 6 months of treatment, she developed scrofuloderma which had to be surgically removed. After 1 year of follow-up, the lesions had totally cleared.

A case of primary tuberculous chancre of the vulva is reported. Although a tuberculous infection in an immunocompromised patient is not uncommon, this is the first report of a primary tuberculous infection on the external genitalia in such a patient. The source of infection in this patient could not be determined.

Sequential biopsies of the skin reaction elicited in goats by Glossina morsitans morsitans infected with Trypanosoma (Trypanozoon) brucei were examined histologically to identify and to quantify the cellular populations involved in the reaction. The peak of the tissue response occurred 7-8 days after challenge with infected tsetse and preceded the initial detection of parasitaemia by 4-5 days. Microscopically, the cellular reaction was characterized initially by a marked infiltration of polymorphonuclear leucocytes (PMN) which were replaced by lymphoid cells. Plasma cells and macrophages were numerous during the decline of the skin reaction. Marked enlargement of, and germinal centre formation in the regional lymph node accompanied the development and regression of the chancre. The results suggest that the formation of a chancre is dependent on the skin thickness of the host at the site of tsetse challenge.