Accuracy of clinical diagnosis of genital ulcer disease

Article Abstract:

Genital ulcers may result from any of several infective agents. Appropriate treatment of genital ulcer disease (GUD) depends upon accurate diagnosis, and this can be a problem in developing countries because of poor availability of laboratories, occurrence of mixed infections, and other factors. The accuracy of diagnosis of GUD in 240 mineworkers in South Africa who attended a sexually transmitted disease clinic was studied. A laboratory diagnosis could not be made for 29 subjects. Depending on whether microscopic or blood test results were used, two or more causes were found in 14 or 37 cases, respectively. Haemophilus ducreyi, the bacterial cause of chancroid, was found in 147 patients, herpes simplex virus was found in 7, Chlamydia was found in 7, lymphogranuloma venereum (LGV) was in 8, and syphilis was found in 52 patients. Single infections were diagnosed in 68 percent of cases, including 80 percent for chancroid, 55 percent for syphilis, 27 percent for LGV, and 22 percent in cases of herpes infections. The ulcers from some infections resembled those from other causes, and laboratory results were therefore very important in arriving at correct diagnoses. Because laboratories are limited in developing regions such as areas of South Africa, a strategy for management of genital ulcers is recommended. Because chancroid is the most common cause of GUD in this population, appropriate antibiotics for that infection should be routinely considered, and antibiotics against syphilis should be considered as well. Future research will be needed to establish the rate of infection with human immunodeficiency virus (HIV; the cause of AIDS), and medical management should be reevaluated if HIV prevalence increases in this region. (Consumer Summary produced by Reliance Medical Information, Inc.)

Demographic aspects

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Transport media for Haemophilus ducreyi

Article Abstract:

Haemophilus ducreyi may be grown and maintained on several different types of transport media in the laboratory at low temperatures. Haemophilus ducreyi is the bacterium that causes chancroid, a sexually transmitted disease characterized by ulceration of the genitals. A study compared the use of six different types of transport media to grow Haemophilus ducreyi in the laboratory at different temperatures. Hemophilus ducreyi could not be maintained over a 24-hour period on any of the different types of media at room temperature. It could be maintained on one type of medium over a three-day period and on another type of medium for more than four days at four degrees Centigrade. Haemophilus ducreyi was grown from 71% of the genital swabs from 156 patients with a genital ulcer on the two most effective types of transport media. Haemophilus ducreyi is difficult to grow in the laboratory. This may make it difficult to diagnose some patients suffering from chancroid.

Usage, Culture media (Biology), Culture media

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A history of the detection of Haemophilus ducreyi, 1889-1979

Article Abstract:

Haemophilus ducreyi, an organism which historically has eluded detection, may be the cause of sexually transmitted chancroid and may be detected by its high need for hemin. H. ducreyi was responsible for a large number of chancroid infections in Winnipeg, Canada, in the mid-1970s. Before this, the organism had not been easily isolated for study. Isolation of H. ducreyi in the Canadian outbreak was attained from a patient with an unruptured swollen lymph node in the groin. Researchers found that swabs were more useful in collecting specimens than were aspirates using a Pasteur pipette. Nineteen strains of H. ducreyi from Winnipeg and four reference strains were all found to have a high requirement for the blood substance, hemin. H. ducreyi is named after Augusto Ducrey, an Italian scientist who studied the organism in the late 19th century.

Sexually transmitted disease diagnosis

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