Sexually transmitted infections frequently coexist and are often under-recognized due to overlapping or atypical presentations. We report four cases of concurrent sexually transmitted infections (STIs) in adult males, including various combinations of syphilis, gonorrhea, chancroid, HIV, molluscum contagiosum, and pediculosis pubis. Detailed sexual history, examination, and laboratory confirmation revealed the diagnoses. All patients received appropriate therapy with clinical improvement. Comprehensive evaluation in all STI cases is necessary to prevent misdiagnosis, ensure complete treatment, and reduce community transmission of multiple sexually transmitted pathogens.

We report the complete reference genome sequences of three Haemophilus ducreyi isolates (ITG3105, CIP76118, and TMA3542), generated using Oxford Nanopore and Illumina sequencing, and hybrid assemblies. Each genome has a closed circular chromosome; ITG3105 and TMA3542 also have plasmids. These reference genomes support genomic, epidemiological, and antimicrobial resistance surveillance of H. ducreyi.

Sierra Leone reported its first outbreak of cutaneous Hemophilic ducreyi in November 2025 amid ongoing public health emergencies. The outbreak, initially detected in a primary school in Bombali district, Northern Sierra Leone, resulted in 449 suspected and 96 confirmed cases, primarily among children aged 5-15 years, with no associated deaths. Rapid activation of the district emergency operations center enabled coordinated epidemiologic investigations, active case finding, laboratory confirmation, case management, infection prevention and control, and community engagement. Most ulcers presented on the lower limbs and healed within eight weeks with appropriate wound care as the mainstay and available antibiotics, implemented under an antimicrobial stewardship framework. The outbreak highlights delayed community-level detection, underscoring surveillance gaps relative to the 7-1-7 response framework. Strengthened risk communication, infection prevention, and enhanced laboratory support were critical to the response. This event emphasizes the need for heightened surveillance, standardized chronic ulcer management, and further research into transmission dynamics and comprehensive outbreak response of cutaneous Hemophilic ducreyi infection.

Genital ulcers are a frequent reason for consultation in Primary Care, primarily due to new in sexual practices in recent years. They are caused by different reasons; its origin is usually infectious and they are transmitted through sexual contact. Its etiology can be non-infectious too. This review, focused on Primary Care, aims to provide an updated overview of the clinical characteristics, diagnosis, and management of genital ulcers, both of infectious origin (genital herpes, syphilis, lymphogranuloma venereum, chancroid, and donovanosis) and non-infectious origin (acute Lipschütz vulvar).

Chancroid, caused by Haemophilus ducreyi, is a sexually transmitted genital ulcerative condition associated with inguinal bubo formation. The relative prevalence of chancroid has dramatically declined based on surveillance findings in those few endemic settings where the appropriate diagnostic tools exist; however, laboratory-based diagnostics are lacking to assist clinical management and support etiological surveillance in most parts of the world. Recent yaws surveys within the Western Pacific region indicate that H ducreyi has re-emerged as a frequent cause of chronic skin ulceration. Although there have been no antimicrobial susceptibility studies for three decades, it is assumed that a cure remains possible with extended-spectrum cephalosporins, macrolides, or fluoroquinolones. HIV-1-infected patients require careful followups due to reports of treatment failure with single-dose regimens. Buboes may need additional treatment with either aspiration or excision and drainage.

A 22-year-old incarcerated Saudi man presented with a 2-day history of painful vesicles on the shaft of his circumcised penis that were unrelated to drug use, trauma, exposure to ill persons, or sexual intercourse. Initial laboratory tests were normal, and the patient was initially diagnosed with herpes simplex infection. Due to nonadherence to the initial antiviral treatment, the lesions progressed, leading to a revised diagnosis of chancroid. Subsequent testing ruled out sexually transmitted infections and revealed methicillin-resistant Staphylococcus aureus in the culture of the purulent exudate. Histopathology confirmed balanitis circumscripta plasmacellularis (BCP, zoon's balanitis). The lesion responded well to topical betamethasone, with marked clinical improvement over 2 months. This case highlights that although rare, BCP should be considered in circumcised patients with non-venereal genital lesions. Additionally, it underscores that early histopathological confirmation is essential to avoid misdiagnosis and inappropriate treatment.