García-Pérez Jorge N, Arando Maider
Unidad de ITS y VIH Drassanes - H. Universitari Vall d'Hebron, Barcelona, Spain.
Int J STD AIDS. 2025 Jul;36(8):676-677. doi: 10.1177/09564624251343480. Epub 2025 May 20.
A 64 year old cisgender man attended to our genito-urinary clinic with a 1 week history of a painful genital ulcer after travelling to Madagascar. On physical examination, we observed two small ulcers, each with a fibrinous base and erythematous borders, without associated lymphadenopathy. The initial diagnosis was a genital herpes outbreak. Thus, a seven-day course of Valaciclovir 500 mg twice daily orally was prescribed. An ulcer sample was collected for NAATs including , Herpes simplex virus 1 and 2, Varicella-zoster virus, and . The ulcer NAATs was positive for . Considering the result and the epidemiological background, diagnosis confirmed chancroid. Ceftriaxone 1 g STAT intramuscular was administered with subsequent improvement. Chancroid, caused by is very rare in Europe. Its prevalence in STI clinics has varied from 0% to 0.5%. It must be suspected, especially in travellers to endemic countries in the first days of their return due to its short incubation period.
一名64岁的顺性别男性前往我们的泌尿生殖科诊所就诊，他在前往马达加斯加旅行后出现了为期1周的疼痛性生殖器溃疡病史。体格检查时，我们观察到两个小溃疡，每个溃疡都有纤维蛋白性基底和红斑性边界，无相关淋巴结病。初步诊断为生殖器疱疹发作。因此，开了一个为期7天的伐昔洛韦疗程，每天口服两次，每次500毫克。采集了溃疡样本进行核酸扩增检测，包括杜克雷嗜血杆菌、单纯疱疹病毒1型和2型、水痘-带状疱疹病毒等。溃疡核酸扩增检测结果显示杜克雷嗜血杆菌呈阳性。考虑到检测结果和流行病学背景，确诊为软下疳。立即肌内注射1克头孢曲松，随后病情有所改善。由杜克雷嗜血杆菌引起的软下疳在欧洲非常罕见。其在性传播感染诊所中的患病率从0%到0.5%不等。由于其潜伏期短，对于刚从流行国家返回的旅行者，尤其是在返回后的头几天，必须怀疑该病。
