Clinical Manifestations

Clinical manifestations of lower genital tract infections are as varied and diverse as the etiologies.

Asymptomatic. Although symptoms of genital tract infections generally cause the patient to seek medical attention, a patient with an STD, especially a female, may be free of symptoms (i.e., asymptomatic). For

Figure 58-2 Genital lesions of the skin and mucous membranes that are sexually transmitted. A, Genital heipes showing vesicular lesions. B, Typical chancre of primary ' syphilis. C, Early chancroid lesion of the penis. D, Condyloma acuminatum. (All B photographs from Farrar WE, Wood MJ, limes JA, Hubbs H: Infectious diseases text and color atlas, ed 2, London, 1992, Gower Medical Publishing.)

Syphilis Penis

Figure 58-2 Genital lesions of the skin and mucous membranes that are sexually transmitted. A, Genital heipes showing vesicular lesions. B, Typical chancre of primary ' syphilis. C, Early chancroid lesion of the penis. D, Condyloma acuminatum. (All B photographs from Farrar WE, Wood MJ, limes JA, Hubbs H: Infectious diseases text and color atlas, ed 2, London, 1992, Gower Medical Publishing.)

example, gonorrhea or chlamydia infection in the male is usually obvious because of a urethral discharge, yet females with either or both of these infections may have either minimal symptoms or no symptoms at all. Also, the primary lesion of syphilis (chancre) can be unremarkable and go unnoticed by the patient. Therefore, the lack of symptoms does not guarantee the absence of disease. Unfortunately, these asymptomatic individuals can then serve as reservoirs for infection and unknowingly spread the pathogen to other individuals. Also, as in the case for asymptomatic infections in the female caused by N. gonorrhoeae or C. trachomatis, untreated infections can lead to serious sequelae such as pelvic inflammatory disease or infertility.

Dysuria. Although a frequent presenting symptom associated with urinary tract infection, dysuria can commonly result from an STD caused by organisms such as N. gonorrhoeae, C. trachomatis, and HS V.

Urethral Discharge. The presence of an inflammatory exudate at the tip of the urethral meatus is gene rally only observed in males; the symptoms of urethral infection in females are infrequendy localized. Most males complain of discomfort at the penile tip as well as dysuria. Urethritis may be gonococcal, caused by N. gonorrhoeae, or nongonococcal. Nongonococcal urethritis can be caused by C. trachomatis, Trichomonas vaginalis (less frequendy), and genital mycoplasmas such as Mycoplasma hominis, M.genitalium, and Ureaplasma ureafyticum.

Lesions of the Skin and Mucous Membranes. Numerous organisms can cause genital lesions that are diverse in both their appearance and their associated symptoms (Figure 58-2). The agents and their features of infection are summarized in Table 58-2. Some of these infections, such as genital herpes (caused by HSV) or genital warts (caused by HPVs and discussed in Chapter 51), are common, whereas others, such as lymphogranuloma venereum and granuloma inguinale, are uncommon in the United States. Of note, specific HPVs, referred to as genotypes, infect mucosal cells in the cervix and can cause a progressive spectrum of abnormalities classified as low-grade and high-grade squamous intra-

Table 58-2 Summary of Common Causes of Genital Lesions of the Skin and Mucous Membranes

Agent

Disease

Lesion

Major Associated Symptoms

Herpes simplex virus

Genital herpes

Papules, vesicles (blisters), pustules, and/or ulcers

Multiple lesions that are usually painful »id tender, can recur (see Figure 58-2, A)

Treponema pallidum

Primary syphilis

Genital ulcer (chancre)

Usually a single lesion, painless; lesion has even edges, represents the first of three stages of syphilis (see Figure 58-2, B)

^Haemophilus ducreyi - ■ i

Chancroid

Papule that becomes pustular and ulcerates (chancroid); mufflple ulcers may develop

Ulcer is deeply Invasive, tender, painful, and purulent in appearance; edges of lesion are ragged (see Figure 58-2, C)

Chlamydia trachomatis serotype L1,L2, and L3

Lymphogranuloma venereum

Small ulcer or vesicle that heals spontaneously without leaving a scar

After lesion heals, painful, swollen lymph nodes (lymphadenopathy) develop 2-6 weeks later; tever and chills; severe lymphatic obstruction and lymphedema can develop

Calymmatobacterlum granulomatis

Granuloma inguinale

Single or multiple subcutaneous nodules

Indolent and chronic course; nodules enlarge and erode through the skin, producing a deep red, sharply defined ulr Mis painless

[Human papillomavirus |

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Bacterial Vaginosis Facts

Bacterial Vaginosis Facts

This fact sheet is designed to provide you with information on Bacterial Vaginosis. Bacterial vaginosis is an abnormal vaginal condition that is characterized by vaginal discharge and results from an overgrowth of atypical bacteria in the vagina.

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Responses

  • grimalda
    How many infectious diseases do we have in panis?
    3 years ago
  • selam
    How is a healed penile syphilis sore?
    2 years ago
  • POPPY
    Can it be syphilis that make penis to peel and pain?
    2 years ago

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