Soft ulcer (or venereal ulcer) belongs to the group of STD (sexually transmitted diseases), i.e. sexually transmitted diseases. In our latitudes, it occurs sporadically, but due to the very dynamic development of tourism, it is worth being aware of the he alth risks involved. What are the causes and symptoms of a venereal ulcer? How is a soft ulcer treated?

Soft ulcer( Venereal ulcer ) is an infectious disease caused by Gram-negative bacteria - bacilliHaemophilus ducreyi . It is spread through sexual contact. It is mainly found in hot climates and affects developing countries.

Shankroid(as it is also called a soft ulcer) is still common in Africa, Southeast Asia and the Caribbean.

It is believed to be the most common cause of genital ulceration in some parts of the world. It is worth noting that venereal ulcer is considered to be an important factor increasing the risk of HIV infection.

Soft ulcer: risk factors

Situations conducive to infection with the stickH.ducreyiconcern basically all venereal diseases. The main risk factors are:

  • using the so-called "sex-tourism" in the areas of endemic occurrence of the microorganism
  • sex without condom
  • casual sex
  • relationships with multiple partners
  • lack of proper hygiene in the genital area
  • low socioeconomic status

Soft ulcer: symptoms and course

The infection occurs during intercourse with a previously infected person.H.ducreyisticks penetrate the body through microtrauma to the skin and mucous membranes of the genital organs. The hatching period is asymptomatic for 1-2 weeks (average 5-7 days). Then, a primary lesion appears at the site of bacterial penetration, which may take the appearance of a spot, lump or pustule.

Subsequently, cell necrosis and ulceration occur under the influence of bacterial toxins. The ulcer can be single, usually in men, or multiple, which is more common in women. Irregular ulcers usually have sharp edges and soft, red edges. Whatit is a typical feature of it, it is very painful. The bottom is lined with granulation, which breaks easily, causing bleeding. They are often covered with a yellow-gray oozing purulent discharge.

The most common sites of venereal ulceration in men are:

  • foreskin
  • groove fast
  • penile glans
  • around the mouth of the urethra
  • scrotum

In women, ulcers are usually located on the labia majora. Their bilateral involvement gives the characteristic symptom of "kissing ulcers". Subsequently, the following may be occupied:

  • vaginal vestibule
  • clitoris
  • cervix
  • anal area

When deeper female organs are infected, the infection may not manifest as an externally localized ulcer. Then the main ailments may be:

  • dysuria (painful urination, burning)
  • dyspareunia (pain during intercourse)
  • upławy
  • general symptoms such as fever and weakness.

In 50% of patients infected with soft ulcer, the lymph nodes may become enlarged. It is more often seen in men. Regional lymphadenopathy accompanying skin lesions is usually located unilaterally in the inguinal area. Enlarged nodes are usually painful. If left untreated, they can ulcerate and soften, and consequently lead to the formation of hard-to-heal fistulas.

Advanced ulceration in the genital area and anus can lead to extensive tissue destruction. Especially when the lesions become superinfected by anaerobic bacteria. A rapidly spreading and deeply penetrating form of gangrene may then develop.

Skin changes caused by the soft ulcer stick can also be found in other parts of the body. Some sexual behavior contributes to the formation of primary changes in the oral cavity, and autoinoculation (self-infection through, for example, contaminated hands) can cause ulcers located, for example, on the back, abdomen, arms or the inside of the thigh.

Soft ulcer: diagnosis

Objective diagnostic methods confirming infection, including classic bacterial culture on special media, are expensive and not available. An alternative and faster method may be the isolation of the genetic material of the pathogen by means of the polymerase chain reaction, or PCR. In this case, the problem may also be high cost and insufficient availability.

For this reason, the diagnosis of a venereal ulcer is based onlargely on a reliably collected interview, thorough examination and diagnosis with the so-called foreclosure. Shankroid should be differentiated from another, but at first glance, a similar disease through sexual contact - syphilis. The features that distinguish the primary lesion occurring in syphilis, i.e. the "hard ulcer" from the soft ulcer, are: hard consistency of the edges, painlessness, no features of purulent discharge.

All patients should be diagnosed for other STD disease entities, such as gonorrhea, chlamydiosis or herpes. Common risk factors lead to the frequent comorbidity of sexually transmitted diseases. Due to the increased susceptibility to HIV infection, diagnostics also in this direction is strongly recommended.

Soft ulcer: treatment

Antibiotic therapy is the treatment of choice, as in other infections of bacterial etiology. It should be implemented as soon as possible. Correctly applied, it reduces symptoms, significantly reduces the risk of complications and prevents further transmission of the infection. The most commonly used antibiotics in this case are:

  • Azithromycin and erythromycin (macrolides)
  • Ceftriaxone (3rd generation cephalosporin)
  • Ciprofloxacin (fluoroquinolone)

A very important aspect is the treatment of sexual partners of a person with symptomatic soft ulcer. People who have sexual contact with the infected (especially during the 10 days preceding the onset of symptoms) should be closely monitored and treated, even in the absence of lesions (they may still be asymptomatic).

Surgical treatment involves drainage of pus from the affected lymph nodes.

Soft ulcer: prognosis

Proper, early treatment makes the prognosis of soft ulcer very favorable. Shallow local lesions usually disappear within a week. Deeper ulcers may take longer to heal and leave scars. Failure to respond to treatment may suggest co-infection with another STD pathogen. Potential, most dangerous complications of a soft ulcer are:

  • phimosis
  • inflammation of the glans
  • perforations and fistulas within abscessed lymph nodes

Soft ulcer: prevention

A very important role in the treatment process is played by the patient's he alth education in the sphere of sexual contacts. The basic principles of preventing sexually transmitted diseases include: avoiding casual sexual contact (especially with "high-risk" people, i.e. prostitutes), avoiding contact with multiple partners,use of condoms and compliance with intimate hygiene. The patient should exercise complete restraint until complete recovery.

Category:

Infectious diseases