Nelson Textbook of Pediatrics 22nd Edition | Painful genital ulcer (soft chancre), painful inguinal lymphadenitis (bubo), sexually transmitted infection, co-infection with HIV, syphilis, HSV. Treatment: azithromycin, ceftriaxone, ciprofloxacin, erythromycin. Diagnosis: clinical + exclusion of syphilis/HSV.
🌐 paeds.online — Pakistan's Pediatric Platform| Condition | Ulcer Characteristics | Lymphadenopathy | Pain |
|---|---|---|---|
| Chancroid (H. ducreyi) | Soft, ragged edges, non-indurated, purulent base, multiple | Painful suppurative bubo (unilateral in ~50%) | Severely painful |
| Syphilis (primary) | Firm, indurated, clean base, solitary | Non-suppurative, firm, rubbery | Painless |
| Genital herpes (HSV) | Vesicular then ulcers, shallow, multiple | Tender, bilateral | Painful |
| Lymphogranuloma venereum (LGV) | Small papule/ulcer (heals quickly) | Painful suppurative bubo (unilateral) | Painful nodes |
| Granuloma inguinale (Klebsiella granulomatis) | Beefy red, friable, non-tender | Pseudobubo (subcutaneous granuloma) | Painless |
Note: Diagnose chancroid by exclusion of syphilis (darkfield/serology) and HSV (PCR/culture).