Detection Of Chancroid And The Other Etiology Of Genital Ulcer Disease

ObjectivesTo screen the best selective culture media for haemophilus ducreyi in region and To investigate the etiology of genital ulcer disease In sexually transmitted disease clinics.MethodsThere were nine swabs which were taken from the genital ulceration in a same patient. Five swabs to be inoculated in five self-made culture media which are composed of V-Agar,GC-CtS,C-HgCh,MH-HBC(Modified) and MH-HBC. With the positive outcome for haemophilus ducreyi inoculation in hand, five biochemical tests, that is, alkaline phosphatase,catalase test,nitrate reduction,oxidase test and porphyin test would then be used to identify further; One swab to be inoculated in culture media for monilia; One swab to be Gram strained to investigate trichomonas vaginalis,monilia and haemophilus ducreyi; One swab to be used for Dark field microscopy to investigate treponema pallidum; One swab to be Preserved; The same time the patients were tested with Serology test for syphilis(Rapid plasma regain test and Treponema pallidum particle agglutination) and genital herpes (Herpes simplex virus-DNA).ResultS134 men and 29 women were evaluated. There was no colony of haemophilus ducreyi grewing in selective culture media. According to clinic and laboratory testing, there were 37 (22.70%, 37/163) cases of syphilis, 57 (34.97%, 57/163) cases of genital herpes, 4 (2.45% 4/163 ) cases of co-infection of syphilis and genital herpes, 5 (3.07% 5/163) cases ofinfusorian, 2 (1.25%, 2/163) cases of co-infection of syphilis and infusorian, 1 (0.06%, 1/163) cases of co-infection of genital herpes and infusorian, 19 (11.67%, 19/163) cases of candidiasis, 3 (1.84%, 3/163) cases of co-infection of syphilis and candidiasis, 3 (1.84%, 3/163) cases of co-infection of genital herpes and candidiasis, 2 cases of co-infection of genital herpes and HIV, 15 (9.20%, 15/163) cases of co-infection in total, no chancroid was found, no pathogen was detected in remaining 54 (33. 13%, 54/163) cases. Most of the patients had no general symptom, local pain is most (49.26%) within the patients who had clinical symptom, and the next were pruritus (17.65%) and Buming sensation (13.24%). Most of the lesions were situated in coronary sulcus(42.54%) in men and on labium majus pudendi (51.72%) in women, then were foreskin (30.60%) in men and labium minus pudendi (31.03%) in women. Ulcer (77.91%) was most of the types of skin lesion, then were phlycten,crust,pustule and lymphadenectasis in groin.Conclusion1. In all the genital samples, no one could flourish colony normally in five culture medium, the explanation may be: (1) lower rate of chancroid; (2) no one chancroid in all patients with genital ulceration actually。With modern techniques in China, definitive chancroid could be diagnosed infrequently, but yet, as a clinical dermatologist, the diagnosis for chancroid should be kept in mind, especially when the multiple ulcers are painful and with adenopathy in groin simultaneously, it may present alone, or just as a member of co-infection family of genital ulcerated diseases.2. Genital herpes and syphilis predominate in patiets with genital ulcer diseases (GUD)in sexuallytransmitted disease clinics, Genital herpes emerged as a leading cause of GUD; Candidiasis and infusorian also are cause of GUD; There is no laborary-confirmed case of chancroid; Co-infection is an universal phenomenon of GUD.3. The study showed that there is a strong correlation between genital herpes and HIV infection.