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[Microbiological study of male genital ulcers. Apropos of 75 cases]
1Service de Bactériologie-Virologie, Hôpital Saint-Louis, Paris, France.
Abstract:
Between November 1986 and June 1987, the microbial aetiology of genital ulcers was assessed in 75 male patients attending the Sexually Transmitted Disease (STD) clinic in Hôpital Saint-Louis, Paris. Evidence of Haemophilus ducreyi was found in 18 patients (24%), Herpes simplex virus in 19 (25.3%). Syphilis was diagnosed on the basis of dark field microscopy and/or positive serology test in 19 patients (25.3%). Lymphogranuloma venereum was not diagnosed in any patient. Primary pathogens were not identified from the remaining 19 (25.3%) men. Neisseria gonorrhoea was isolated in five patients, from the ulcer in three cases, from the urethra in two. Asymptomatic urethral carriage of Chlamydia trachomatis was culture proven in seven cases. The presence of IgM antibodies to C. trachomatis at a titre greater than 40 found in 17 patients was a indication of a current chlamydial infection. Three patients (4%) were discovered to be HIV-1 positive.
Insights
Genital ulcers in Paris were primarily caused by Herpes simplex virus and syphilis, with Haemophilus ducreyi also identified. Some infections remained unidentified, and a small percentage of patients had HIV-1.
Area of Science:
- Microbiology
- Infectious Diseases
- Dermatology
Background:
- Genital ulcers are a common manifestation of sexually transmitted infections (STIs).
- Accurate etiological diagnosis is crucial for effective treatment and public health management of STIs.
- Understanding the prevalence of different pathogens causing genital ulcers informs clinical practice and prevention strategies.
Purpose of the Study:
- To determine the microbial causes of genital ulcers in male patients attending an STD clinic.
- To assess the prevalence of specific STIs including Haemophilus ducreyi, Herpes simplex virus, syphilis, and Chlamydia trachomatis.
- To identify unidentified pathogens and co-infections in patients presenting with genital ulcers.
Main Methods:
- Prospective study of 75 male patients with genital ulcers at Hôpital Saint-Louis, Paris.
- Microbiological investigations included dark field microscopy, serological tests, and cultures for Neisseria gonorrhoea and Chlamydia trachomatis.
- Serological testing for IgM antibodies to Chlamydia trachomatis was performed.
Main Results:
- Herpes simplex virus (25.3%) and syphilis (25.3%) were the most frequent causes of genital ulcers.
- Haemophilus ducreyi was identified in 24% of patients.
- Chlamydia trachomatis infection was confirmed in 7 cases (asymptomatic urethral carriage) and 17 patients showed evidence of current infection via IgM antibodies.
- Neisseria gonorrhoea was isolated in 5 patients.
- No cases of Lymphogranuloma venereum were diagnosed.
- Primary pathogens were not identified in 25.3% of cases.
- HIV-1 positivity was found in 4% of patients.
Conclusions:
- Herpes simplex virus, syphilis, and Haemophilus ducreyi are significant etiological agents of genital ulcers in this Parisian male population.
- Chlamydia trachomatis represents an important cause of genital infections, including asymptomatic carriage.
- A notable proportion of genital ulcers remain without a definitive microbial diagnosis, warranting further investigation.
- The study highlights the diverse microbial landscape of genital ulcers and the importance of comprehensive diagnostic approaches.