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Genital ulcers: etiology, clinical diagnosis, and associated human immunodeficiency virus infection in Kingston, Jamaica.
Clin Infect Dis. 1999 May; 28(5):1086-90.CI

Abstract

Individuals presenting consecutively with genital ulcers in Kingston, Jamaica, underwent serological testing for human immunodeficiency virus (HIV) infection, chlamydial infection, and syphilis. Ulcer material was analyzed by multiplex polymerase chain reaction (M-PCR) analysis. DNA from herpes simplex virus (HSV), Haemophilus ducreyi, and Treponema pallidum was detected in 158 (52.0%), 72 (23.7%), and 31 (10.2%) of 304 ulcer specimens. Of the 304 subjects, 67 (22%) were HIV-seropositive and 64 (21%) were T. pallidum-seroreactive. Granuloma inguinale was clinically diagnosed in nine (13.4%) of 67 ulcers negative by M-PCR analysis and in 12 (5.1%) of 237 ulcers positive by M-PCR analysis (P = .03). Lymphogranuloma venereum was clinically diagnosed in eight patients. Compared with M-PCR analysis, the sensitivity and specificity of a clinical diagnosis of syphilis, herpes, and chancroid were 67.7%, 53.8%, and 75% and 91.2%, 83.6%, and 75.4%, respectively. Reactive syphilis serology was 74% sensitive and 85% specific compared with M-PCR analysis. Reported contact with a prostitute in the preceding 3 months was associated with chancroid (P = .009), reactive syphilis serology (P = .011), and HIV infection (P = .007). The relatively poor accuracy of clinical and locally available laboratory diagnoses pleads for syndromic management of genital ulcers in Jamaica. Prevention efforts should be intensified.

Authors+Show Affiliations

Department of Medicine, University of North Carolina at Chapel Hill, USA. BehetsF@aol.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

10452639

Citation

Behets, F M., et al. "Genital Ulcers: Etiology, Clinical Diagnosis, and Associated Human Immunodeficiency Virus Infection in Kingston, Jamaica." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 28, no. 5, 1999, pp. 1086-90.
Behets FM, Brathwaite AR, Hylton-Kong T, et al. Genital ulcers: etiology, clinical diagnosis, and associated human immunodeficiency virus infection in Kingston, Jamaica. Clin Infect Dis. 1999;28(5):1086-90.
Behets, F. M., Brathwaite, A. R., Hylton-Kong, T., Chen, C. Y., Hoffman, I., Weiss, J. B., Morse, S. A., Dallabetta, G., Cohen, M. S., & Figueroa, J. P. (1999). Genital ulcers: etiology, clinical diagnosis, and associated human immunodeficiency virus infection in Kingston, Jamaica. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 28(5), 1086-90.
Behets FM, et al. Genital Ulcers: Etiology, Clinical Diagnosis, and Associated Human Immunodeficiency Virus Infection in Kingston, Jamaica. Clin Infect Dis. 1999;28(5):1086-90. PubMed PMID: 10452639.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Genital ulcers: etiology, clinical diagnosis, and associated human immunodeficiency virus infection in Kingston, Jamaica. AU - Behets,F M, AU - Brathwaite,A R, AU - Hylton-Kong,T, AU - Chen,C Y, AU - Hoffman,I, AU - Weiss,J B, AU - Morse,S A, AU - Dallabetta,G, AU - Cohen,M S, AU - Figueroa,J P, PY - 1999/8/19/pubmed PY - 1999/8/19/medline PY - 1999/8/19/entrez SP - 1086 EP - 90 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 28 IS - 5 N2 - Individuals presenting consecutively with genital ulcers in Kingston, Jamaica, underwent serological testing for human immunodeficiency virus (HIV) infection, chlamydial infection, and syphilis. Ulcer material was analyzed by multiplex polymerase chain reaction (M-PCR) analysis. DNA from herpes simplex virus (HSV), Haemophilus ducreyi, and Treponema pallidum was detected in 158 (52.0%), 72 (23.7%), and 31 (10.2%) of 304 ulcer specimens. Of the 304 subjects, 67 (22%) were HIV-seropositive and 64 (21%) were T. pallidum-seroreactive. Granuloma inguinale was clinically diagnosed in nine (13.4%) of 67 ulcers negative by M-PCR analysis and in 12 (5.1%) of 237 ulcers positive by M-PCR analysis (P = .03). Lymphogranuloma venereum was clinically diagnosed in eight patients. Compared with M-PCR analysis, the sensitivity and specificity of a clinical diagnosis of syphilis, herpes, and chancroid were 67.7%, 53.8%, and 75% and 91.2%, 83.6%, and 75.4%, respectively. Reactive syphilis serology was 74% sensitive and 85% specific compared with M-PCR analysis. Reported contact with a prostitute in the preceding 3 months was associated with chancroid (P = .009), reactive syphilis serology (P = .011), and HIV infection (P = .007). The relatively poor accuracy of clinical and locally available laboratory diagnoses pleads for syndromic management of genital ulcers in Jamaica. Prevention efforts should be intensified. SN - 1058-4838 UR - https://www.unboundmedicine.com/medline/citation/10452639/Genital_ulcers:_etiology_clinical_diagnosis_and_associated_human_immunodeficiency_virus_infection_in_Kingston_Jamaica_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1086/514751 DB - PRIME DP - Unbound Medicine ER -