Chancroid, lymphogranuloma venereum and granuloma inguinale

Genital ulcers are common presentations in sexually transmitted disease clinic settings and, in some developing countries, account for as many as 1 % of primary care visits. Clinical differentiation as to etiology is fraught with error. As a result, syndromic therapy is absolutely necessary and can effectively treat most patients who present with genital ulcer disease. The interactions of genital ulcer disease with HIV continue to be problematic. In many societies, Hemophilus ducreyi is the most important cause of genital ulcers. The biology of this organism is now under intensive investigation and it has proven to be a most intriguing, complex pathogen. Much less progress is occurring with either Calymmatobacterium granulomatis or Chlamydia trachomatis types associated with LGV. Prevention has to be the primary objective and some studies, particularly those from Thailand, suggest that this can be achieved within resource-limited societies.