oro - genital contact : case report . meningitidis group A acquired by Acute urethritis due to Neisseria

tics without improvement. We treated her successfully with local applications of piperazine solution for only eight days, and more than 18 months elapsed since without any recurrence. In chronic cases of sterile pyuria, therefore, urine should be examined for parasites. If the ova or larvae of E vermicularis are found treatment should be by local irrigation ofthe urethra and bladder and vaginal application of piperazine salts. The most probable source of repeated urinary tract infections in our patient was the vagina and not the intestinal tract. This explanation is based on three observations: (1) stools and parianal swabs from her and her husband were repeatedly negative for E vermicularis, (2) her condition responded to topical vaginal treatment, and (3) no antimicrobial or other drug was required to treat this condition. Yours faithfully, Sarman Singh J C Samantaray Section of Parasitology, Department of Medical Microbiology, All India Institute of Medical Sciences, New Delhi 110 029, India