Other sexually transmitted diseases
Ulcus molle (soft chancre)
STD, which is caused by the bacterium Haemophilus ducreyi. Rare in Germany, occurs mainly in tropical countries.
After an incubation period of about 1-5 days (in rare cases up to 30 days) several soft, purulent ulcers develop in the genital region, which are very painful. If no treatment is given, the inguinal lymph nodes may swell and break open. Diagnosis is done by smear, culture and microscopy. Treatment is carried out with antibiotics, with various preparations available.
Lymphogranuloma venerum
STD caused by certain subtypes of chlamydia (Ch. trachomatis, serotype L1-L3). Chlamydia are bacteria that can only multiply within a host cell. Lymphogranuloma venerum occurs mainly in tropical countries.
After an incubation period of 5 - 21 days, a single ulcer forms in the genital region. This usually heals spontaneously and can also go unnoticed. After several weeks, a painful enlargement of the regional lymph nodes occurs (up to the size of a hen’s egg, so-called buboes), which subsequently subside and then break through to the outside. Thick pus is thereby released, and general symptoms such as fever and shivering occur. Untreated, chronic lymphatic swelling and ulcers appear in the genital tract. The infection is identified through direct DNA detection in a smear. Treatment is carried out with antibiotics that are effective against Chlamydia such as tetracyclines (e.g. doxycycline) or macrolides (e.g. erythromycin) for at least 3 weeks.
Granuloma inguinale (Donovanosis)
Another STD that occurs mainly in the tropics is granuloma inguinale. The pathogen is Klebsiella granulomatis. After infection, a tough, painless nodule develops at the entry portal, and in the further course of the infection, further nodules develop in the genital area. The lymph nodes are usually not or only slightly swollen. As the infection progresses, the lymphatic tracts may become blocked, which can lead to chronic lymphatic swelling and even to so-called elephantiasis. The exact diagnosis in cultures or by means of DNA detection can only be done in special laboratories. Therapy is carried out with antibiotics, i.e. macrolides or tetracyclines or,, as an alternative, cotrimoxazole.
Molluscum contagiosum (Dell warts)
These are warts caused by viruses that attack the uppermost layer of the skin. They are transmitted by a smear infection through direct contact or through contaminated objects.
Any part of the body can be affected, so this is not a classical venereal disease, but transmission during sexual intercourse is possible. Mostly children from 2 - 6 years of age are affected, being infected in child care facilities by other children who already have the disease.
After an incubation period of 2 - 7 weeks, the warts, which are about 1 - 5 mm in size, appear with the typical centrally located dent. Lateral pressure or scratching causes the fatty content, which contains infectious viruses, to be released. Careless scratching of the warts can cause them to spread over a large area of the skin.
The treatment is usually first carried out by surgical removal and disinfection of the wart base. The local application of 5% potassium hydroxide solution is also possible. In stubborn cases, Imiquimod can be applied locally as a cream, but this treatment is relatively expensive.
In otherwise healthy patients with no immune deficiency, the disease is usually self-limiting and heals spontaneously after about 6 - 18 months.
