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Video: Ulcus Molle
Ulcus molle (soft chancre) leads to painful ulcers and suppuration of the lymph nodes in the groin area, which are caused by an infection with bacteria (Haemophilus ducreyi). The diagnosis is usually made on the basis of the symptoms. Treatment is with antibiotics…
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In addition to syphilis, gonorrhea and lymphogranuloma venereum, ulcus molle is one of the four classic venereal diseases that are subject to the law on venereal diseases. It occurs ten times more often in men than in women. Transmission occurs almost exclusively during sexual intercourse. Ulcus molle rarely occurs in Austria (and Europe), but it is common in tropical and subtropical areas (especially large cities and ports).
Prevention & Symptoms
Since an infection is only possible during sexual intercourse, condoms protect. After an incubation period of two to seven days, small, painful nodules develop, which break open quickly and form flat, soft, painful ulcers of various sizes with blurred edges and a red border. Deep ulcers lead to tissue destruction. The lymph nodes in the groin are painful, swollen and form an abscess (unilateral lymphadenopathy = bubo). The abscess cavity may rupture, causing pus to drain outward or to spread into surrounding tissue and lead to new lesions. A narrowing of the foreskin (phimosis) or the urethra (urethral stricture) and a urethral fistula can occur as complications.
The diagnosis is made on the basis of the typical symptoms, because the cultivation of pathogens and microscopic identification are difficult. Nevertheless, attempts are usually made to detect the pathogen using a special staining method (Giemsa staining) from a pus sample or from the secretion from the ulcer edge. Antibiotic therapy should be carried out immediately after this material extraction. Tests for other STDs (gonorrhea, syphilis, HIV and herpes etc.) are recommended for additional examinations.
Therapy & aftercare
Treatment is with antibiotics (azithromycin, ceftriaxone, ciprofloxacin, erythromycin). The patient should be observed for at least three months. If the patient suffers from an immune deficiency, antibiotic treatment must be intensified. The sexual partner should also be examined.
According to the Venereal Diseases Act, there is a limited obligation to report venereal diseases (syphilis, gonorrhea, ulcus molle and lymphogranuloma venereum) in Austria. This means that people who do not follow the instructions of the treating doctor will be reported to the health department.
Note Sexual activities must be avoided during treatment.