Ulcerative STDs

Chancroid

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

HSV (usually type 2)

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

Syphilis

1. Cause: Treponema pallidum
2. single nonpainful lesion with punched out base and rolled edges (lesion is highly infectious)
3. Treatment:
   1. 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)