By Mroczkowski, Tomasz F.; Millikan, Larry E.; Parish, Lawrence Charles
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Additional resources for Genital and Perianal Diseases : A Color Handbook
It may primarily involve the inguinal lymph nodes, the anus, and rectum. The inguinal form is more common in men than in women, because the lymphatic drainage of the vagina and cervix is to the retroperitoneal rather than the inguinal lymph nodes. Proctitis is more common in those who practice receptive anal intercourse and is considered to be due to direct inoculation. The presence of unilateral, painful inguinal, and/or femoral lymphadenopathy are its cardinal features. Enlarged lymph nodes are usually firm, and a biopsy reveals small discrete areas of necrosis, surrounded by proliferating epithelioid and endothelial cells.
8 million cases are estimated6; however, a certain group of infected men may remain asymptomatic. Studies from the 1970s and 1980s estimated cases of NGU resulting from chlamydia to range between 35 and 50%2; however, its overall prevalence has been declining, and newer studies predict that chlamydia may now account for as low as 15% of NGU cases7,8. Previously thought to be the most common pathogen in NGU, its prevalence is now thought to be equivalent to or less than that of mycoplasma-associated NGU; moreover, the prevalence of chlamydial NGU varies per age group and is higher among young men1.
Special medium is required and even under the best conditions and in highly experienced laboratories, the sensitivity of culture is only about 75%. The laboratory diagnosis of chancroid was reviewed in detail by Lewis11. 2 USA Centers for Disease Control and Prevention recommended regimens for the treatment of chancroid Azithromycin, 1 g PO in a single dose OR Ceftriaxone 250 mg IM in a single dose OR Ciprofloxacin 500 mg PO twice daily for 3 days OR Erythromycin base 500 mg PO 3 times daily for 7 days From: Workowski KA, Berman SM; Centers for Disease Control and Prevention (2010).