Genital Ulcer Dksease

Question 1

herpes simplex virus (HSV)

Answer 1

• multiple painful genital ulcers (with a characteristic erythematous base), dysuria (likely due to irritation from the ulcers), tender lymphadenopathy (common with primary genital HSV infection), and systemic symptoms (fever, headache) in the setting of having a new sexual partner
• characteristic vesicles are often absent.
  can be diagnosed using polymerase chain reaction (PCR), direct fluorescence antibody, viral culture (low sensitivity), or Tzanck smear (showing multinucleated giant cells).

Acyclovir is a guanosine chain analog that inhibits multiplication of herpes simplex virus, a double-stranded DNA virus.

Question 2

syphilis

Answer 2

• gram negative spirochete Treponema pallidum
• Single, painless ulcer at inoculation site with heaped-up borders & clean base followed by a rash and systemic symptoms
• Diagnostic tests: VDRL/RPR,
  Dark-field microscopy
• treated with penicillin, a bactericidal β-lactam antibiotic that works by inhibiting cell wall synthesis.

Question 3

Gonorrhea, caused by Neisseria gonorrhoeae

Answer 3

• common cause of urethritis, cervicitis, and pelvic inflammatory disease in sexually active females.
• Gram stain can reveal gram-negative diplococci

Question 4

Chancroid (due to Haemophilus ducreyi)

Answer 4

• Deep, purulent, painful ulcers with matted/suppurative lymphadenitis
• presents with purulent ulcers with “ragged” borders and suppurative
  lymphadenopathy.
• Gram stain may occasionally reveal gram-negative rods in a “school of fish” chain.
• Gram stain & culture
  PCR

Question 5

Klebsiella granulomatis

Answer 5

Painless, progressive, red serpiginous ulcerative lesions without lymphadenopathy
- Gram stain & culture (difficult)
Biopsy (Donovan bodies)