A seventeen-year-old girl presents with painful ulcerated lesions on her inner labia. Her boyfriend is with her; they tell you that they have been each other's only sexual partners. What would your care of this couple include?
According to Roett, Mayor, and Uduhiri (2012), herpes simplex virus infection and syphilis are the most common causes of genital ulcers in the United States. Although other infectious such as chancroid, lymphogranuloma venereum, granuloma inguinale (donovanosis), secondary bacterial infections, and fungi; noninfectious etiologies such as sexual trauma, psoriasis, Behçet syndrome, and fixed drug eruptions, can also lead to painful ulcerated lesions within the inner labia area as the patient describes. The plan of care for the girl and her boyfriend is to …show more content…
Although in settings “where chancroid is prevalent, a test for Haemophilus ducreyi should also be performed” (CDC, 2011). Here are some recommended tests for evaluation of genital, anal, or perianal ulcers according to CDC: 1) syphilis serology and darkfield examination; 2) culture for HSV or PCR testing for HSV; and 3) serologic testing for type-specific HSV antibody.
Prior to confirming the exact cause of the ulcers, both parties should be treated accordingly. Roett et al., 2012 from the American Family Physicians recommends seven to ten days of oral acyclovir and five days for recurrent episodes or Famciclovir and valacyclovir for alternative therapies. The CDC (2011) recommends one dose of intramuscular penicillin G benzathine to treat genital ulcers caused by primary syphilis; for chancroid, a single dose of intramuscular ceftriaxone or oral azithromycin, ciprofloxacin, or erythromycin; lymphogranuloma venereum and donovanosis are treated with 21 days of oral doxycycline. Additionally, treatment of noninfectious causes of genital ulcers varies by etiology and ranges from topical wound care for ulcers caused by sexual trauma to consideration of subcutaneous
According to Roett, Mayor, and Uduhiri (2012), herpes simplex virus infection and syphilis are the most common causes of genital ulcers in the United States. Although other infectious such as chancroid, lymphogranuloma venereum, granuloma inguinale (donovanosis), secondary bacterial infections, and fungi; noninfectious etiologies such as sexual trauma, psoriasis, Behçet syndrome, and fixed drug eruptions, can also lead to painful ulcerated lesions within the inner labia area as the patient describes. The plan of care for the girl and her boyfriend is to …show more content…
Although in settings “where chancroid is prevalent, a test for Haemophilus ducreyi should also be performed” (CDC, 2011). Here are some recommended tests for evaluation of genital, anal, or perianal ulcers according to CDC: 1) syphilis serology and darkfield examination; 2) culture for HSV or PCR testing for HSV; and 3) serologic testing for type-specific HSV antibody.
Prior to confirming the exact cause of the ulcers, both parties should be treated accordingly. Roett et al., 2012 from the American Family Physicians recommends seven to ten days of oral acyclovir and five days for recurrent episodes or Famciclovir and valacyclovir for alternative therapies. The CDC (2011) recommends one dose of intramuscular penicillin G benzathine to treat genital ulcers caused by primary syphilis; for chancroid, a single dose of intramuscular ceftriaxone or oral azithromycin, ciprofloxacin, or erythromycin; lymphogranuloma venereum and donovanosis are treated with 21 days of oral doxycycline. Additionally, treatment of noninfectious causes of genital ulcers varies by etiology and ranges from topical wound care for ulcers caused by sexual trauma to consideration of subcutaneous