ArticlePloS one2013
Etiology of genital ulcer disease in a sexually transmitted infection reference center in Manaus, Brazilian Amazon.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 3 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 3 syntheses or guidelines pooled it, 34 citations in OpenAlex.
- Diagnosing sexually transmitted infections in resource-constrained settings: challenges and ways forward.Journal of the International AIDS Society · 2019Pooled it
- Herpes simplex virus type 1 epidemiology in Latin America and the Caribbean: Systematic review and meta-analytics.PloS one · 2019Pooled it
- Comparison of Diagnostic Accuracy of PCR Targeting the 47-Kilodalton Protein Membrane Gene of Treponema pallidum and PCR Targeting the DNA Polymerase I Gene: Systematic Review and Meta-analysis.Journal of clinical microbiology · 2015Pooled it
- Infections caused byClinical microbiology reviews · 2024Review
- Genital ulcer disease: Study of factors associated and utility of rapid diagnostic methods in current pandemic.Journal of family medicine and primary care · 2024Article
- Molecular Characterization of Genital and Extragenital Lesions With the PlexPCR VHS Assay in Patients Diagnosed With Syphilis.Open forum infectious diseases · 2023Article
- Epidemiological Survey of Human Alphaherpesvirus 2 (HSV-2) Infection in Indigenous People of Dourados Municipality, Central Brazil.Tropical medicine and infectious disease · 2023Article
- Use of a Multiplex PCR Assay To Assess the Presence of Treponema pallidum in Mucocutaneous Ulcerations in Patients with Suspected Syphilis.Journal of clinical microbiology · 2021Article
- Brazilian Protocol for Sexually Transmitted Infections, 2020: infections that cause genital ulcers.Revista da Sociedade Brasileira de Medicina Tropical · 2021Article
- A Young Patient with Painful Penile Lesions.Cureus · 2019Article
- Novel variants of human herpesvirus 2 from Brazilian HIV-1 coinfected subjects.Memorias do Instituto Oswaldo Cruz · 2018Article
- High prevalence of curable sexually transmitted infections among pregnant women in a rural county hospital in Kilifi, Kenya.PloS one · 2017Article
- Genital ulcers caused by sexually transmitted agents.Anais brasileiros de dermatologiaArticle
- Etiological profile of male urethritis and genital ulcer disease and antimicrobial susceptibility of Neisseria gonorrhoeae in Southeastern Brazil.The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious DiseasesArticle
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo determine the etiology and factors associated with genital ulcer disease (GUD) among patients presenting to a sexually transmitted infections clinic in Manaus, Brazil; and to compare a multiplex polymerase chain reaction (M-PCR) assay for the diagnosis of GUD with standard methods.
methodsUlcer swabs were collected and used for Tzanck test and processed in an M-PCR to detect herpes simplex virus (HSV-1/2), Treponema pallidum (T. pallidum), and Haemophilus ducreyi (H. ducreyi). Sera were tested for HIV and syphilis antibodies. Multivariable analysis was used to measure the association between clinical aspects and GUD. M-PCR results were compared with syphilis serology and Tzanck tests.
resultsOverall, 434 GUD samples were evaluated, 84.8% from men. DNA from HSV-2 was detected in 55.3% of GUD samples, T. pallidum in 8.3%, HSV-1 in 3.2%, and 32.5% of GUD specimens were negative for the DNA of all three pathogens. No cases of H. ducreyi were identified. HIV serology among GUD patients was 3.2%. Treponemal antibodies and Tzanck test positivity for genital herpes was detected in 25 (5.8%) and in 125 (30.3%) of GUD patients, respectively. In multivariable analysis genital herpes etiology by M-PCR was associated with the vesicular, multiple and recurrent lesions whereas T. pallidum with non-vesicular, non-recurrent lesions. Compared to M-PCR, syphilis serology was 27.8% sensitive and 96.2% specific whereas Tzanck test was 43.8% sensitive and 88.9% specific.
conclusionsThe predominance of genital herpes etiology suggests a revision of existing national syndromic treatment guidelines in Brazil to include antiherpetic treatment for all GUD patients. The use of M-PCR can significantly improve the diagnosis of GUD and provide a greater sensitivity than standard diagnostics.
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