Basic evaluations:
Urine status, urine sediment, ESR or CRP, blood count
Specific evaluations in case of:
Vaginal discharge:
Urethral- or cervical swab for gonococcus, general germs (bacterial vaginosis), chlamydia (Special extraction equipment required), trichomonas vaginalis (urine sediment from fresh morning urine), candida Genital ulcers or vesicles:
Urethral or cervical swab for chlamydia (PCR extraction equipment), herpes simplex (PCR extraction equipment), lues serology
Papular changes:
Lues serology (on suspicion of condyloma lata), HPV (on suspicion of condyloma acuminata, urethral or cervical swab, as cell rich as possible for PCR)
On suspicion of septicemia:
Blood cultures
Index:
Differential diagnosis in patients with genital ulcers or inguinal lymphadenopathy
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Illness
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Clinical findings
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Laboratory evaluations
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Herpes simplex infection
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Several painful surficial ulcerations. Earlier lesions are vesicular.
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HSV-antigen confirmation:
Vesicular swab, vesicular contents, with special extraction equipment for IFT-test. Alternatively HSV-DNA-PCR
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Syphilis (Treponema pallidum)
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Painless, clearly defined, hardened ulcer with painless regional lymphadenopathy
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Syphilis serology
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Chancroid (Hemophilus ducreyi)
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Several painful genital ulcerations with painful lymphadenopathy
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Genital swab, microscopy. Difficult to diagnose.
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Inguinal granuloma (Calymmatobacterium granulomatis)
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Slightly painful ulcer, which follows a painless papule
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Skin scrapings. Microscopy after Giemsa-staining
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Lymphogranuloma venereum (Chlamydia trachomatis)
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Chlamydia-DNA confirmation, serology
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