Presentation
Unfortunately, on the 10 th day of therapy, she presented with features of sepsis and died before further diagnostic investigations could be conducted. [annalsafrmed.org]
Other than ulceration, enlarged lymph nodes in the groin area may be present, along with blisters and sores. [bio.libretexts.org]
The diagnosis may be difficult, as its presentation varies and histopathological findings may resemble other conditions. [mdedge.com]
Furthermore, none of the control group presented with oral or genital ulcers. [jamanetwork.com]
Lupus vulgaris of the glans penis: a rare presentation. Indian Dermatol Online J 2014 ; 5: 309 – 311. Google Scholar Crossref Medline 7. Ramesh, V, Ramam, M, Pahwa, P The clinical presentations of penile tuberculosis. [journals.sagepub.com]
Entire Body System
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Infectious Mononucleosis
Conclusion: EBV DNA was found in genital ulcer specimens obtained 10 days before symptoms of EBV-related infectious mononucleosis were apparent. EBV should be considered as an etiologic agent of acute, non-venereal genital ulcers. [nature.com]
Further tests will be directed by the symptoms of the underlying illness but should include tests for infectious mononucleosis. Biopsy of the ulcer should include surrounding skin. Findings are nonspecific in NSGU. [dermnetnz.org]
Epstein-Barr virus (EBV) infection with or without other signs and symptoms of infectious mononucleosis Syphilis: sharply demarcated, firm and indurated; usually single ulcer; nontender lymphadenopathy Chancroid (Haemophilus ducreyi): These are painful [cancertherapyadvisor.com]
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Episodic Pain
With the first clinical episode, painful ulcers that may have begun as small papules or vesicles. Small lesions may coalesce into larger ulcers. [cancertherapyadvisor.com]
Respiratoric
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Aspiration
Lymphogranuloma venereum erythromycin PO: 1 g 2 times daily or 500 mg 4 times daily for 14 days or doxycycline PO: 100 mg 2 times daily for 14 days Fluctuant lymph nodes may be aspirated through healthy skin as required. [medicalguidelines.msf.org]
Labs Herpes Simplex Virus Testing HSV PCR from ulcer scraping or vessicle aspirate (preferred obver HSV culture) HSV Serology (type specific) Chancroid testing (if high Incidence in community) Outside the U.S., PCR testing may be available, which is much [fpnotebook.com]
Painful, unilateral, inguinal adenitis occurs in one-half of patients with chancroid and may develop into buboes. 19, 20 Fluctuant buboes may rupture spontaneously if not aspirated or incised and drained. [aafp.org]
The test specimen is taken from the lesion or aspirated from a lymph node Herpes simplex virus (HSV): It is usually clinically diagnosed based on the characteristic signs and symptoms Sometimes, a culture or polymerase chain reaction (PCR) test of the [dovemed.com]
Repetitive aspiration may reduce the incidence of rupture and secondary bacterial infection. [antimicrobe.org]
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Pharyngitis
First presented in 1973, juvenile gangrenous vasculitis of the scrotum with an acute painful scrotal ulcer preceded by symptomatic pharyngeal infections can be considered as the male counterpart of ulcus vulvae acutum, and the future clinical survey should [onlinelibrary.wiley.com]
[…] circular ulcers on an erythematous base Smooth margin and base Enlarged, nonfluctuant and tender inguinal lymph nodes most common in primary infection Ulcers usually painful and/or pruritic Genital pain Constitutional symptoms, such as fever, malaise and pharyngitis [canada.ca]
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Sputum
Genital tuberculosis, often caused by direct genital contact with infected sputum, can also present as genital ulcer. References [ edit ] External links [ edit ] Genital herpes - self-care, A.D.A.M. [en.wikipedia.org]
Search for Mycobacterium tuberculosis in sputum and urine was negative by direct microscopic examination with Ziehl-Neelsen staining. Testing for syphilis serology was negative. [journals.athmsi.org]
No acid–fast bacilli were seen in sputum. Mantoux test was also negative. Although motivated and counseled, the patient and her husband did not give consent for taking biopsy. [ijstd.org]
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Sore Throat
A previously healthy 14-year-old girl with no history of sexual activity developed fever, sore throat, and low back pain; a day later, five painful ulcers appeared over her external genitalia. [nature.com]
Gastrointestinal
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Dysphagia
On day 15 of GU, she developed sore throat and dysphagia, but no fever. Examination revealed exudative tonsillitis and cervical lymphadenopathy; the ulcers were granulating and less tender. [nature.com]
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Dysphagia
On day 15 of GU, she developed sore throat and dysphagia, but no fever. Examination revealed exudative tonsillitis and cervical lymphadenopathy; the ulcers were granulating and less tender. [nature.com]
Jaw & Teeth
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Recurrent Oral Ulceration
The case of a 22-year-old female who presented with fever, recurrent oral ulcers, genital ulcers, arthralgia, and erythema nodosum is presented here. A diagnosis of BD based on clinical criteria was made. [bmbtrj.org]
The criteria include recurrent oral ulceration with two of the following four criteria: recurrent genital ulcerations, eye lesions (uveitis or retinal vasculitis), skin lesions (erythema nodosum or foliculitis) and or positive ‘pathergy test’ (Occurrence [ncbi.nlm.nih.gov]
CASE REPORT The patient was a 29 year old woman with Behçet’s disease who had had recurrent oral ulcers from age 5 and genital ulcers, arthralgia, and uveitis from age 23. [ard.bmj.com]
Skin
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Excoriation
Excoriations can cause accidental trauma, usually in the setting of any severely itchy dermatitis. The surrounding skin is abnormal and the onset is rarely acute. [medicinetoday.com.au]
Urogenital
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Vulvar Pain
Two days after her initial evaluation, the patient complained of increasing vulvar pain. A clinical examination found liquid accumulation in the vulva, with ulcers on the labia minora and majora, vagina, and cervix. [sjogrenssyndromenews.com]
Description Lipschütz ulcer is a rare condition characterised by the rapid onset of vulvar painful necrotic ulcerations. It typically occurs in sexually inactive girls and may be preceded by influenza-like symptoms. [ncbi.nlm.nih.gov]
Workup
Microbiology
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Chlamydia Trachomatis
Direct immunofluorescence detection on genital ulcer scraping was negative for Chlamydia trachomatis and Treponema pallidum. [journals.athmsi.org]
Explore these free sample topics: -- The first section of this topic is shown below -- PATHOGENS Common: Herpes simplex virus Treponema pallidum (primary syphilis or chancre) Haemophilus ducreyi ( chancroid ) Chlamydia trachomatis L1, L2 and L3 serovars [hopkinsguides.com]
Among the most common are Herpes simplex virus (HSV), the genital herpes agent; Treponema pallidum, that causes syphilis; Chlamydia trachomatis, the cause of chlamydia; and Haemophilus ducreyi, the chancroid agent. [bio.libretexts.org]
Less frequent infectious causes include chancroid ( Haemophilus ducreyi ), lymphogranuloma venereum ( Chlamydia trachomatis, serovars L1-3 ), and granuloma inguinale (Calymmatobacterium granulomatis). [mdmag.com]
Chlamydia trachomatis (lymphogranuloma venereum) and Calymmatobacterium granulomatis (donovanosis) are less frequent. [medicalguidelines.msf.org]
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Staphylococcus Aureus
Risks for methicillin-resistant Staphylococcus aureus colonization or infection among patients with HIV infection. HIV Med 2010;11:389-394. [sajhivmed.org.za]
HLA Type
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HLA-B5
The prevalence of HLA-B5 in North Indians is high. There are few reports of BD from India. Only two major studies from North India and one from South India exist. [bmbtrj.org]
Treatment
[…] episodic treatment during clinically-apparent genital ulcerations. [clinicaltrials.gov]
[…] lack of response to high dose long term prednisolone treatment. [ard.bmj.com]
Selection criteria: Randomized controlled trials of any treatment intervention aimed at curing genital ulcer disease compared with an alternative treatment, placebo, or no treatment. [cochrane.org]
treatment are now very clear. [journals.lww.com]
Genital herpes – Local treatment: clean the area with soap and water. – Antiviral treatment: aciclovir PO In patients with a first episode, treatment may reduce the duration of symptom when given within 5 days after the onset of symptoms: 400 mg 3 times [medicalguidelines.msf.org]
Prognosis
This case represents a rare differential diagnosis of genital ulceration, with an exuberant clinical presentation, often requiring hospitalisation for pain control and yet with good prognosis. [ncbi.nlm.nih.gov]
The prognosis is severe due to the ocular, neurological, and arterial involvement. [bmbtrj.org]
What Is the Prognosis for Genital Herpes? Treatment of genital herpes does not cure the disease. The virus usually lives (in an inactive form) in an infected person throughout their lifetime. [emedicinehealth.com]
Etiology
In general usage the term refers to genital ulcerations from a sexually transmitted disease (STD), which is the most common etiology; however, nonsexually acquired illnesses, including infectious (bacterial skin infections, fungi) or noninfectious etiologies [accessmedicine.mhmedical.com]
Etiology of genital ulcer disease and association with HIV infection in Malawi. [tandfonline.com]
Then, in the absence of infectious etiology, probable diagnosis of Lipschutz ulcer was made, tablet prednisolone (30mg) and tablet dapsone (100 mg bd) [1] were started. After 1 month of follow-up, genital ulcers started healing [Figure 2]. [ijstd.org]
Etiology STIs For most young, sexually active patients with genital ulcer disease (GUD), etiology is related to an STI. Most often it is due to herpes simplex virus type 1 or 2 (HSV-1 or HSV-2), causing genital herpes. [canada.ca]
Epidemiology
To improve the outcome, treatment often starts before identification is complete, with medications chosen based on symptoms and epidemiological circumstances. [bio.libretexts.org]
Carbapenem-resistant Enterobacteriaceae: epidemiology and prevention. Clin Infect Dis. 2011 Jul 1. 53(1):60-7. [Medline]. van Duin D, Bonomo RA. [medscape.com]
Procaine Ceftriaxone Erythromycin Tetracycline benzylpenicillin Tetracycline Trimethoprim/Sulfamethoxazole Penicillin allergy and non-pregnant Doxycycline Tetracycline The decision to treat for chancroid, granuloma inguinale or LGV depends on the local epidemiology [apps.who.int]
HSV lesions begin as vesicles and primary syphilis as a papule) and epidemiologic circumstances (e.g., high incidence of disease among populations and communities and travel history). [cdc.gov]
Robertson Professor of Reproductive Epidemiology at the School of Public Health. For the study, Dr. Gray and his colleagues studied 248 adults who recently acquired HIV and a control group of 496 HIV-negative adults, all living in Rakia, Uganda. [jhsph.edu]
Pathophysiology
With viremia a component in the pathophysiology of the primary herpes simplex virus infection, nonspecific complaints of fever, malaise, headache and photophobia may be documented. [antimicrobe.org]
Prevention
Division of STD Prevention, Centers for Disease Control Prevention, Sexually transmitted disease surveillance, 1996, 1997 Atlanta CDC 2. [academic.oup.com]
C 15, 16 Prevention Avoiding sexual intercourse during outbreaks does not prevent transmission of HSV infection. [aafp.org]
Conclusion Our findings emphasise the importance of HIV testing and retesting and strengthening STI/HIV prevention programs for men in South Africa, particularly HIV negative youth that may benefit from prevention services. [tandfonline.com]
The researchers suggest that suppressing HSV-2 and genital ulcer disease could be an important element in treating HIV and preventing transmission to partners. [jhsph.edu]
Preventive Services Task Force recommends that healthcare providers routinely screen all sexually-active individuals for HSV infections Male condoms or female condoms prevent STIs to a certain extent. [dovemed.com]