Background: Erysipelas is an acute, recurrent infectious disease caused by Group A β-hemolytic streptococcus. Recurrence occurs in 12–29% of patients, and complications in approximately 31%. International studies indicate that age, sex, and skin conditions are key factors influencing complications and recurrence. In Mongolia, the incidence of erysipelas has not steadily declined, and there is a lack of studies investigating clinical and laboratory predictors of complications and recurrence. Aim:: This study aimed to investigate clinical and laboratory predictors of complications and recurrence among erysipelas cases registered in Mongolia. Materials and Methods: A retrospective cross-sectional study design was employed. A total of 165 patients hospitalized with a diagnosis of erysipelas at the National Center for Communicable Diseases between 2020 and 2024 were randomly selected. Data were collected based on the “Clinical Guidelines for Erysipelas.” Statistical analysis was performed using SPSS-26, and ROC curve analysis along with regression models were used to determine risk and predictive factors. A p-value <0.05 was considered statistically significant. Results: The mean age of participants was 50.4±14.2 years; 76.5% were female, and 32.1% were herders. Recurrence was observed in 55.1% of patients (42.8% repeated episodes, 57.2% recurrent cases), and complications occurred in 10.3%. Among patients with complications, lesions were most commonly located on the face (41.2%) and predominantly presented as erythematous-bullous forms (70.6%). The neutrophil-to-lymphocyte ratio was 7.1 (AUC: 0.85, 95% CI: 0.79–0.91, p=0.001), and the systemic inflammatory response index was 3.9 (AUC: 0.93, 95% CI: 0.88–0.98, p=0.001), indicating high levels. Multivariable regression analysis showed that risk factors for complications included age >45 years (aOR=1.8, 95% CI: 1.2–2.7, p=0.004), female sex (aOR=2.8, 95% CI: 1.7–4.6, p=0.001), and occupation (herder) (aOR=2.6, 95% CI: 1.3–5.4, p=0.001). Chronic tonsillitis was significantly associated with recurrence (OR=3.8, 95% CI: 2.5–5.7, p=0.001). Cox regression analysis demonstrated that each additional year of age increased the risk of complications by 2% (HR=1.02, 95% CI: 1.01–1.03, p=0.003), while the presence of chronic tonsillitis increased the risk of recurrence by 7.69 times (HR=7.69, 95% CI: 5.15–11.49, p=0.001). Conclusion Cellular ratio indicators in erysipelas are useful for assessing inflammatory activity and disease progression. Age, sex, occupation, and the presence of chronic tonsillitis significantly influence the risk of complications and recurrence in erysipelas.

Background: Congenital syphilis is a serious infection transmitted from an infected mother to the fetus during pregnancy, potentially leading to adverse outcomes such as miscarriage, stillbirth, preterm birth, or neonatal death. The global COVID-19 pandemic and associated lockdown measures have posed significant challenges not only to individuals but also to national socio-economic systems, adversely affecting the quality and accessibility of healthcare services. Aim: This study aimed to compare the incidence of congenital syphilis in Mongolia during the pre-COVID-19 period (2016–2020) and the post-COVID-19 period (2021–2025). Materials and Methods: A cross-sectional study design was employed. Data from all 361 registered cases of congenital syphilis between 2016 and 2025 were included in the analysis. Results: The incidence of congenital syphilis per 100,000 live births decreased from 65.8 in 2016–2020 to 34.5 in 2021–2025, representing a 47.6% reduction (RR=0.52, 95% CI: 0.42–0.66, p<0.001). Overall, 67% of cases were concentrated in Ulaanbaatar. The proportion of cases among mothers aged 15–19 years increased from 11.5% to 21.3%, and the majority of mothers had completed secondary education. Conclusion Although the incidence of congenital syphilis declined significantly following the COVID-19 pandemic, 13.0% of pregnant women receiving antenatal care did not undergo serological testing. This underscores the need to strengthen surveillance and reporting systems and to implement continuous education and awareness programs, particularly targeting young women and mothers.

Background: Mongolia, as a country with a high burden of liver disease caused by viral infections, has prioritized reducing the spread of viral hepatitis and sexually transmitted infections (STIs) in line with the WHO strategy for 2022–2030. Orders A/133 (2023) and A/18 (2024) issued by the Ministry of Health mandate that healthcare providers initiate screening of hospitalized patients for hepatitis B and C viruses, syphilis, and HIV infection. Among infectious diseases registered in Mongolia, STIs rank among the leading causes, with more than 40% of reported cases being newly diagnosed syphilis. Hepatitis C virus (HCV) infection and syphilis are transmitted via the parenteral route, can lead to chronic disease, and co-infection represents a serious condition that accelerates liver damage and negatively affects treatment outcomes. Syphilis infection places additional stress on liver function and exacerbates HCV-related inflammation. Aim: This study aimed to investigate how syphilis co-infection affects the biochemical and clinical course of acute hepatitis C virus infection. Materials and Methods: A retrospective, hospital-based cross-sectional study design was used. A total of 74 patients diagnosed with acute hepatitis C virus infection and treated at the National Center for Communicable Diseases between 2025 and 2026 were randomly selected. Data were collected from medical records. Patients were divided into two groups based on syphilis serology results: HCV mono-infection and HCV with syphilis co-infection. Differences between variables in the two groups were analyzed using the T-test, with statistical analysis performed using SPSS version 26. A p-value <0.05 was considered statistically significant. Results: Of the study participants, 17 (23%) had syphilis co-infection. There were no statistically significant differences in age and sex between the groups (p=0.982). In the co-infected group, 23.5% had high RPR titers (indicative of active/new infection). Clinically, general signs of infection and intoxication (35.3%), fatigue (100%), dyspeptic syndrome (100%), and intoxication syndrome (100%) were predominant. Biochemical analysis showed significantly higher levels in the co-infected group compared to the mono-infected group: total bilirubin (192.4 vs 110.5 μmol/L, p<0.01), alkaline phosphatase (245.8 vs 132.1 U/L, p=0.004), and ALT (1240.5 vs 850.2 U/L, p=0.03). Kaplan–Meier analysis demonstrated that the mean time for ALT normalization was longer in the co-infected group (26.4 days) compared to the mono-infected group (20.7 days) (p=0.006), indicating prolonged recovery. Conclusion Syphilis co-infection worsens the clinical course of acute hepatitis C, deepens jaundice and cholestatic syndrome, and prolongs the normalization of biochemical parameters.

Background: Sexual risk behavior is an important issue that requires early identification and assessment because it is associated with sexually transmitted infections, particularly HIV and syphilis, unintended pregnancy, and adverse reproductive, psychosocial, and mental health outcomes. Clients with sexual risk behaviors may also experience fear, anxiety, depression, shame, and stigma. Therefore, psychiatrists have an important role in identifying these risks, providing counseling, and referring clients for further care when needed. However, in routine clinical practice, obtaining a full sexual health history and identifying sexual risk behavior through interview may be limited. Aim: This study aimed to assess psychiatrists’ current practice in asking about sexual risk behavior, their basic knowledge of HIV/STIs, attitudes toward clients with sexual risk behavior, and training needs. Materials and Methods: A descriptive cross-sectional questionnaire survey was conducted between July and October 2025. The study included 158 psychiatrists working at the National Center for Mental Health, district and local health centers, and private clinics providing mental health services. Data were collected using a questionnaire developed by the research team. The survey included socio-demographic and professional characteristics, practice related to asking about sexual risk behavior, knowledge of HIV/STIs, attitudes toward clients with sexual risk behavior, and institutional training needs. Data were analyzed using Microsoft Excel and SPSS version 23. Descriptive statistics, chi-square tests, non-parametric tests, Spearman correlation, and linear regression models were applied. Results: Of the participants, 78.5% were female, and the mean age was 36.8±10.2 years. Psychiatrists asked a mean of 6.2±5.7 out of 22 questions required to identify sexual risk behavior, indicating that only a limited number of relevant questions were routinely covered in clinical practice. General questions such as marital status, age at first sexual intercourse, sexual health-related complaints, and history of sexually transmitted infections were asked more frequently, whereas questions on sex with commercial sex workers, casual and multiple sexual partners in the last 3 months, and sexual orientation were asked less often. Male psychiatrists (p=0.036) and psychiatrists working in private practice (p=0.034) asked significantly more questions. Among the 131 participants eligible for HIV/STI knowledge assessment, 29.8% had adequate knowledge and 70.2% had inadequate knowledge. Misconceptions about mosquito transmission of HIV remained common. The mean attitude score among 131 psychiatrists was 14.3±1.7. Significant differences were observed across age groups (p=0.004), and psychiatrists with 0–10 years of experience had higher attitude scores than those with more than 10 years of experience (p=0.026). A weak but statistically significant negative correlation was found between years of work as a psychiatrist and attitude score toward clients with sexual risk behavior (Spearman r=-0.304, p<0.001; n=131). In addition, 69.0% of participants had previously worked with clients with sexual risk behavior, and 48.1% had provided care to such clients in the last 12 months. Conclusion The practice of asking about sexual risk behavior among psychiatrists remains limited and non-standardized. Differences were observed according to physician sex and type of institution. Continuous workplace-based training and practical guidelines are needed to strengthen psychiatrists’ capacity to identify sexual risk behavior and provide appropriate care.

Background: Transitioning HIV care toward a client-centered model is a key strategy for improving treatment outcomes and controlling the spread of HIV infection. Evaluating service accessibility, quality, and client satisfaction is essential for improving strategic planning and strengthening health service delivery. Aim: To assess the accessibility and quality of client-centered health services among people living with HIV. Materials and methods: A facility-based cross-sectional study was conducted. Data were collected using structured questionnaires from 50 clients and 30 health managers who participated voluntarily. The reliability of the questionnaire, measured using Cronbach’s alpha, ranged from 0.673 to 0.783. Data were analyzed using SPSS version 23.0 with both descriptive and analytical statistical methods. Quantitative variables were summarized using means and standard deviations, and statistical significance was determined at p < 0.05. Results: HIV-related services were found to be highly centralized at the NCCD, particularly for blood testing (96.8%) and inpatient care (71.4%). Overall, 84% of clients reported the need to access services outside NCCD, with the highest demand for internal medicine (32%), dental services (14%), and surgical services (14%). Among the barriers to accessing care, 75% were related to stigma and discrimination associated with HIV status, while 18% were linked to healthcare workers’ attitudes. In addition, 56.7% of healthcare facilities had not conducted HIV-related training, and only 40% had dedicated rooms ensuring confidentiality. Client satisfaction was strongly correlated with healthcare providers’ attitudes and communication (R = 0.614) and confidentiality (R = 0.578), both showing significant associations (p = 0.000). Conclusion HIV services remain highly centralized at NCCD, while the readiness of primary and referral healthcare facilities remains insufficient. Strengthening a client-centered care approach requires improving healthcare workers’ attitudes and communication, ensuring confidentiality, and implementing continuous HIV-related training for healthcare providers.

Background: Fitz-Hugh-Curtis syndrome is a rare condition most commonly caused by Chlamydia trachomatis infection. It is associated with pelvic inflammatory disease and inflammation of the liver capsule (perihepatitis). Due to its clinical presentation, early detection and careful differential diagnosis are essential. Case Presentation: We present the case of a 17-year-old female with a prior history of latent syphilis that had been treated. She developed progressively worsening lower abdominal pain and was admitted through the emergency department. Based on computed tomography (CT) findings, she was diagnosed with Fitz-Hugh-Curtis syndrome and received appropriate treatment. Conclusion Fitz-Hugh-Curtis syndrome should be suspected in sexually active women presenting with severe right upper quadrant abdominal pain requiring emergency care, especially when ultrasound findings show no abnormalities of the gallbladder but reveal signs of peritoneal inflammation in the abdominal and pelvic cavities. In such cases, abdominal CT plays a crucial role in diagnosis. Performing dynamic CT imaging, including the arterial phase, may improve diagnostic accuracy.

Background: Mycoplasma and Ureaplasma species are considered part of the normal genitourinary microbiota; however, when present in excessive amounts, they may become pathogenic and cause symptoms such as dysuria, vaginal discharge, and lower abdominal pain. Due to the lack of specific clinical manifestations, these infections may remain undiagnosed or be misidentified as other inflammatory conditions. Disseminated infection caused by Mycoplasma and Ureaplasma is rare. Case Presentation: A 27-year-old female presented with progressive pelvic pain and was initially discharged without a definitive diagnosis. The disease subsequently worsened, and laboratory as well as imaging studies revealed a complicated pelvic infection with concurrent pregnancy. Despite surgical intervention and intensive treatment, the patient died due to severe pelvic purulent inflammation, sepsis, septic shock, and multiple organ failure. Multiplex PCR testing was positive for Mycoplasma genitalium (+), Mycoplasma hominis (+), Ureaplasma parvum (+), and Ureaplasma urealyticum (+). The final clinical diagnosis was consistent with the pathological findings. Conclusion Pelvic disease caused by Mycoplasma and Ureaplasma often presents with nonspecific symptoms, making differential diagnosis challenging. In this case, concurrent pregnancy and the use of analgesic medication may have obscured the disease progression. Comprehensive clinical assessment, close observation, appropriate diagnostic testing, and contact tracing with epidemiological investigation are essential in suspected sexually transmitted infections.

Background: Congenital syphilis is an infection caused by transplacental transmission of Treponema pallidum from mother to fetus and remains a significant cause of neonatal morbidity and mortality worldwide. Clinically, it is a multisystem disease with manifestations resembling those of TORCH infections and may also occur as a co-infection with these pathogens. Case Presentation: We report a case of a 28-year-old woman with a prior history of syphilis who had been treated and followed up, presenting with preterm delivery at 31–32 weeks of gestation during her third pregnancy. The neonate subsequently died due to complications associated with a concomitant perinatal infection. Conclusion Early screening during pregnancy, appropriate follow-up, identification of reinfection, and timely treatment remain key strategies for reducing the burden of congenital syphilis.