Ulcerative STDs

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Chancroid

  • cause: H ducreyi
  • multiple painful lesions
  • painful inguinal lymphadenopathy (buboes) that may become an abscess and rupture
  • Treatment:
  • clean area with soap and water
  • I&D any fluctuant buboes
  • treat for other STDs as well
  • Antibiotics:
  • Azithromycin 1g PO x 1 OR
  • Cetriaxone 250 mg IM x 1 with Erythromycin 500 mg PO QID x 7 days OR
  • Ciprofloxacin 500mg PO BID x 3 days


HSV (usually type 2)

  • multiple painful lesions
  • no buboes (occ shoddy LAD)
  • more common in African Americans
  • starts with small clumps of blisters that may have been preceded with local pain, tingling, itching, and burning
  • +/- constiutional symptoms (fever, fatigue, myalgias, headaches)
  • Treatment:
  • antivirals
  • acyclovir
  • famciclovir
  • valacyclovir
  • pain medications


Syphilis

  • Cause: Treponema pallidum
  • single nonpainful lesion with punched out base and rolled edges (lesion is highly infectious)
  • Treatment:
  • Benzathine penicillin G 2.4 million units IM x 1 (for primary or secondary infection)


Source

Tung 7/2010 (adapted from emedicine)

DONALDSON 5/4/07 (adapted from Birbaumer)

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