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17 - Ulcerative Sexually Transmitted Diseases

from Part I - Systems

Published online by Cambridge University Press:  15 December 2009

By
Diane Birmbaumer
Edited by
Rachel L. Chin
Diane Birmbaumer
Affiliation:
Professor of Clinical Medicine, David Geffen School of Medicine at UCLA; Associate Program Director, Department of Emergency Medicine, Harbor–UCLA Medical Center, Torrance, CA
Rachel L. Chin
Affiliation:
University of California, San Francisco
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Summary

INTRODUCTION – AGENTS

Sexually transmitted infections can be divided into those that cause genital ulcers and those that do not. In North America, ulcerative sexually transmitted diseases are most commonly caused by herpes genitalis, syphilis, and, occasionally, chancroid; much rarer causes include lymphogranuloma venereum and granuloma inguinale. Definitive diagnostic tests often are not available in the acute care setting, and empiric treatment with close follow-up is often the best approach.

HERPES GENITALIS

Epidemiology

Genital herpes infection is caused by herpes simplex virus (HSV) types 1 and 2. This is by far the most common cause of ulcerating genital disease in North America: More than 50 million persons in the United States have the disease. Most U.S. cases are caused by HSV-2.

Clinical Features

Herpes genitalis can present with a broad range of symptoms. Serologic testing suggests that many infected patients are asymptomatic or have minimal symptoms. Those with an initial genital infection caused by HSV-1 tend to have milder symptoms than those infected with HSV-2. In addition, patients who already have antibodies to HSV-1 (e.g., those with a history of fever blisters) often have milder symptoms with initial HSV-2 genital infection. Symptomatic patients with genital infection caused by HSV-2 who have no prior HSV antibodies tend to present with the most severe disease. In all cases of genital herpes, recurrences may occur and are more common in patients infected with HSV-2.

Type
Chapter
Information
Emergency Management of Infectious Diseases , pp. 89 - 96
Publisher: Cambridge University Press
Print publication year: 2008

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References

ACOG. Practice bulletin: management of herpes in pregnancy. Clinical guidelines for obstetrician-gynecologists. Int J Gynaecol Obstet 2000;68:165–73.
Armstrong, G L, Schillinger, J, Markowitz, L, et al. Incidence of herpes simplex type 2 infection in the United States. Am J Epidemiol 2001;153:912–20.CrossRefGoogle ScholarPubMed
Augenbraum, M.Treatment of latent and tertiary syphilis. Hosp Pract 2000;35(4):89–95.CrossRefGoogle Scholar
Centers for Disease Control and Prevention (CDC). Brief report: a treatment failures in syphilis infections – San Francisco, California, 2002–2003. MMWR 2004;53(9):197–8.
Centers for Disease Control and Prevention (CDC). Sex CDC. Sexually transmitted diseases: treatment guidelines, 2006. MMWR 2006;55(RR-11).
Gene, M, Ledger, W J. Syphilis in pregnancy. Sex Transm Infect 2000;76(2):73–9.Google Scholar
Kimberlin, D W, Rouse, D J. Genital herpes. N Engl J Med 2004;350:1970–7.CrossRefGoogle ScholarPubMed
Lukehart, S A, Godornes, C, Molini, B J, et al. Macrolide resistance in Treponema pallidum in the United States and Ireland. N Engl J Med 2004;351:154–8.CrossRefGoogle ScholarPubMed
Singh, A E, Romanowki, B. Syphilis: review with emphasis on clinical, epidemiological, and some biologic features; Clin Microbiol Rev 1999;12(2):187–209.Google ScholarPubMed
Steiner, I, Biran, I. Herpes simplex encephalitis. Curr Treat Options Infect Dis 2002;4:491–9.Google Scholar
Whittington, W L, Celum, C L, Cent, A, et al. Use of a glycoprotein G-based type-specific assay to detect antibodies to herpes simplex virus type among personnel attending sexually transmitted disease clinics. Sex Transm Dis 2001;28:99–104.CrossRefGoogle Scholar
Ernst, A A, Marvez-Valls, E, Martin, D H. Incision and drainage versus aspiration of fluctuant buboes in the emergency department during an epidemic of chancroid. Sex Transm Dis 1995;22:217–20.CrossRefGoogle ScholarPubMed
Lewis, D A. Diagnostic tests for chancroid. Sex Transm Infect 2000;76:137–41.CrossRefGoogle ScholarPubMed
Steen, R, Dallabetta, G, Genital ulcer disease control and HIV prevention. J Clin Virol 2004;29:143–51.CrossRefGoogle ScholarPubMed

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  • Ulcerative Sexually Transmitted Diseases
    • By Diane Birmbaumer, Professor of Clinical Medicine, David Geffen School of Medicine at UCLA; Associate Program Director, Department of Emergency Medicine, Harbor–UCLA Medical Center, Torrance, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Book: Emergency Management of Infectious Diseases
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547454.018
Available formats
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To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Ulcerative Sexually Transmitted Diseases
    • By Diane Birmbaumer, Professor of Clinical Medicine, David Geffen School of Medicine at UCLA; Associate Program Director, Department of Emergency Medicine, Harbor–UCLA Medical Center, Torrance, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Book: Emergency Management of Infectious Diseases
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547454.018
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Ulcerative Sexually Transmitted Diseases
    • By Diane Birmbaumer, Professor of Clinical Medicine, David Geffen School of Medicine at UCLA; Associate Program Director, Department of Emergency Medicine, Harbor–UCLA Medical Center, Torrance, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Book: Emergency Management of Infectious Diseases
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547454.018
Available formats
×