Tropical stisTropical sexually transmitted infections (excluding lymphogranuloma venereum)
Section snippets
Chancroid
Chancroid is an STI causing painful genital sores. Inguinal lymphadenopathy is common. The causative organism is a Gram-negative bacterium, Haemophilus ducreyi.
Donovanosis (granuloma inguinale)
Donovanosis is a chronic, progressive bacterial infection that usually involves the genital region. The causative organism has been reclassified as Klebsiella granulomatis comb nov based on phylogenetic analysis,1 though there is debate about this; some authorities consider the original nomenclature, Calymmatobacterium granulomatis, to be more appropriate.2
Syndromic management
Syndromic management involves the identification of a syndrome (e.g. genital ulceration, inguinal bubo) comprising symptoms and signs that are associated with several infections. A clinical flow chart (Figure 4) is used to facilitate step-by-step management. Treatment is usually prescribed for the most likely causes of the syndrome.
Syndromic management is suitable for resource-poor settings and enables treatment to be given at the first attendance without the need for specialized skills or
Endemic non-venereal treponematoses
Yaws, pinta and endemic syphilis are non-venereal treponemal infections with many similarities to sexually transmitted syphilis (Figure 5).6 Immune responses are similar, making the interpretation of serological tests difficult. However, PCR and whole genome fingerprinting techniques have been able to differentiate between the different treponemal strains but these tests have limited availability. There is no congenital transmission.
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Single dose azithromycin versus benzathine benzylpenicillin for treatment of yaws in children in Papua New Guinea: an open-label, non inferiority, randomized trial
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(2012) - et al.
Phylogenetic evidence for reclassification of Calymmatobacterium granulomatis as Klebsiella granulomatis comb nov
Int J Syst Bacteriol
(1999) - et al.
Phylogenetic analysis of Calymmatobacterium granulomatis based on 16S sequences
J Med Microbiol
(1999) Donovanosis in Australia: going, going
Sex Transm Infect
(2005)