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Genital Ulcer Diseases


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Three most common GUDs
Genital Herpes, Syphilis, Chancroid
Chancroid Ulcer Description
very deep, locally desctructive lesion, painful, pus filled, bleeds easily
Genital Herpes Ulcer Description
chronic, recurring, very shallow small clusters of ulcers, begin as vesicles or blisters, become painful
Syphilis Ulcer Description
single, relatively painless, firm to touch, mid size
Bug causing syphilis
Treponema pallidum
Presentation of Primary Syphilis
ulcer, single painless indurated with clear base (no blister/pus), hard sores
Presentation of Secondary Syphilis
wks-mos after primary infxn, fever, headache, muscle/joint pain, loss of appetite, skin rash (variable, can involve palms/soles), adenopathy, hepatitis, nephritis, aseptic meningitis
Presentation of Tertiary Syphilis
Benign Late Syphilis (gumma), CV syphilis, Neurosyphilis
Describe Gumma
benign late syphilis, gumma nodules, generally benign, can form in organs and be fatal, DTH response to organism
Describe Cardiovascular Syphilis
spirochetes infect small vessels in aortic wall --> aneurysms and aortic valve insufficiency
Describe Neurosyphilis
General Paresis: direct invasion of cerebrum by t. pallidum; Tabes Dorsalis: infection of small arteries of spinal cord
Clinical Presentation of neurosyphilitic general paresis
chronic meningitis, cerebral atrophy, perivascular infiltrates, psychiatric and neurologic condition
Stages of Latent Syphilis
Early: first year, most likely transmission; Late: after 1 year
Describe Early Congenital Syphilis
snuffles to sanguinous nasal discharge, variable skin rash, condyloma lata, skeletal involvement, hematological abnormalities, CNS involvement
Describe Late Congenital Syphilis
skeletal malformations, dental abnormalities, inflammatory lesions (interstitial keratitis), deafness, knee inflammation, neurosyphilis, paroxysmal cold hemoglobinuria
Hutchinson's Triad
for late congenital syphilis: Dental Findings, Interstitial Keratitis, Neural Deafness
Lab Diagnosis of Syphilis
Darkfield microscopy, nontreponemal tests: ab against cardiolipin antigens released from damaged tissues; Treponemal tests: detect Ab against treponemal antigens (Captia/FTA-abs); MCB: PCR
Syphilis Treatment
IM Pen
Chancroid caused by
Haemophilus ducreyi
Clinical Presentation of Chancroid
Single or multiple relatively deep, tender ulcers, no induration, granular base, irregular border, bleed easily, purulent, development of bubo (abscessed LN)

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