Rare STIs

Question 1

Lymphogranuloma venereum : what is it?

Answer 1

Disease of lymphatic tissue caused by chlamydia trachomatis (serotypes L1, L2, and L3)

Question 2

Clinical presentation of Lymphogranuloma venereum

Answer 2

1. Primary lesion: small painless papule/vesicle with evolves rapidly to painless erosion
2. Inguinal stage: Typically unilateral inguinal LAD with viral prodrome symptoms. The lymph nodes become tender and drain (buboes) and can see “groove sign”
   - can see proctitis in men/women when rectum was site of innoculation

Question 3

Genitoanorectal syndrome

Answer 3

Chronic edema (elephantiasis) of the female external genitals as a late manifestation of lymphatic obstruction

Question 4

Diagnosis of Lymphogranuloma venereum

Answer 4

Nucleic acid amplification for chlamydia

Question 5

Tx of Lymphogranuloma venereum

Answer 5

Azithro or doxy

Question 6

Chancroid etiology

Answer 6

H. ducreyi

Question 7

Chancroid clinical presentation

Answer 7

painful red papule that becomes pustular and ulcerates with red halo (deeper ulcer than herpes)
- can get multiple ulcers 2/2 auto-innoculation

Question 8

Tx of chancroid

Answer 8

azithro/cipro

Question 9

Granuloma inguinale

Answer 9

Tropical genital ulceration due to Donovanosis

Question 10

Bacterial etiology of granuloma inguinale

Answer 10

Klebsiella granulomatis

Question 11

Clinical presentation of granuloma inguinale

Answer 11

Single/multiple papules/nodules/ulcers on genitals that evolves into a painless broad superficial ulcer with rolled margin and beefy granulation tissue base that is raised up above the skin surface

• typically not associated with inguinal LAD or constitutional sx but local destruction
• ulcers bleed to touch