Protocolo diagnóstico y terapéutico de las úlceras genitales

A small number of infectious agents cause most genital ulcers, but they can also be produced by non-infectious diseases. They constitute one of the most frequent reasons for consultation in sexually transmitted infections centers. In Spain, the most common causes of genital ulcers are herpes (HSV 1 and 2) and syphilis (Treponema pallidum). Chancroid (Haemophilus ducreyi), lymphogranuloma venereum (Chlamydia trachomatis) and inguinal granuloma (Klebsiella granulomatis) are other infectious diseases, much less frequent, that produce genital ulcers. The history and physical examination are essential to guide the diagnosis, but often can be misleading. Therefore confirmatory microbiological tests must be performed at least for syphilis and herpes. Performing these tests should not delay the start of treatment for the most likely causes. Waiting for diagnostic confirmation, empirical treatment for more than one etiology (e.g. herpes and syphilis) can be initiated.