Pathogenic microbial flora of genital ulcers in Sheffield with particular reference to herpes simplex virus and Haemophilus ducreyi.

Abstract

The pathogenic microbial flora of genital ulcers in 161 (80 men and 81 women) unselected patients was studied prospectively. In only 1 case was Treponema pallidum responsible; herpes simplex virus was considered the cause of 130 (80.8%) genital ulcers. H. ducreyi was isolated from 46 (28.6%) patients, most commonly as a secondary pathogen in herpetic lesions. Two or more pathogens were isolated from the ulcers in 67 (41.6%) patients; no pathogens were isolated in 21 (13%) patients. These results indicate an urgent need for antiviral treatment to reduce the local reservoir of genital herpes. They also challenge traditional concepts about the prevalence of H. ducreyi in Britain and call for a reappraisal of its role in the causation of genital ulcers.