Genital Ulcer Adenopathy Syndromes

PATHOGENS

Infectious Causes

• Common Sexually Transmitted Infections:
  
  • Herpes simplex virus
  • Treponema pallidum (primary syphilis or chancre)
  • Chlamydia trachomatis L1, L2 and L3 serovars causing lymphogranuloma venereum (LGV) (relatively uncommon in the U.S., but outbreaks, particularly in men who have sex with men, have been reported)
• Sexually Transmitted Infections which are very rare in the United States:
  • Haemophilus ducreyi (chancroid)
  • Klebsiella granulomatis (formerly Calymmatobacterium granulomatis) causing granuloma inguinale (donovanosis)
• Other infections which have been occasionally reported to cause genital ulcers:
  • Primary HIV
  • Phthirus pubis
  • Sarcoptes scabei with pyoderma
  • EBV
  • Tuberculosis
  • Entamoeba histolytica
  • Monkeypox
    
    • In 2022 an outbreak of monkeypox was reported, with some individuals noted to have genital ulcers, among other clinical features.

Non-Infectious Causes

• Trauma, fixed drug eruption, Behçets syndrome, malignancy, Crohn’s disease, Lipschutz ulcer