Around 7 million new cases of ulcus molle are counted worldwide every year. The venereal disease occurs mainly in the tropical regions of
- Africa,
- Southeast Asia and
- Latin America
very frequently. The pathogen responsible, Haemophilus ducreyi, is particularly widespread there.
In Africa, ulcus molle is the most common cause of ulcers in the genital area of men. In Germany and other European countries, however, ulcus molle occurs rather rarely. In most cases, travelers returning from the tropics who have had sexual intercourse with prostitutes are affected.
The causative agent of ulcus molle is the bacterium Haemophilus ducreyi. This is a rod-shaped, gram-negative bacterium of the Pasteurellaceae family. The bacterium is very sensitive to cold and dehydration. This explains its widespread distribution in tropical countries.
In most cases, the ulcus molle pathogen is transmitted through sexual intercourse.
During sexual intercourse, the bacteria penetrate the tissue via tiny skin lesions or the mucous membrane. There they cause the soft ulcers that give ulcus molle its name.
In Germany and Europe, the bacterium that causes ulcus molle is rather rare.
The first symptoms usually appear around 3 to 10 days after infection.
Initially, one or more painless nodules appear at the site of entry of the bacteria in the genital area. Over the following days, they develop into roundish-oval, thumbnail-sized and very painful ulcers. These can reach a size of one to two centimeters.
These ulcers are soft and have an irregularly jagged, sharp edge and a purulent surface.
In men, these typical ulcers usually occur
- on the shaft of the penis,
- on the foreskin and
- on the glans
occur.
Women often carry the ulcus molle pathogen without developing symptoms. If the ulcer formation typical of the ulcus molle occurs, it is usually
- the entrance to the vagina,
- the labia and
- the vaginal vestibule
are affected.
If left untreated, the bacterial pathogens spread further into the body. Painful, inflammatory swelling of the lymph nodes in the groin area can then develop. These are also known as buboes.
If these swellings of the lymph nodes remain untreated, they can fester and possibly break through the skin to the outside.
The ulcus molle is diagnosed on the basis of the characteristic symptoms and by detecting the pathogen.
The examination is usually carried out by a gynecologist or urologist. If a patient exhibits the characteristic symptoms, the doctor can usually already make a diagnosis of ulcus molle.
In addition, the doctor usually takes a swab from the ulcer. In the laboratory, the tissue sample is examined for the pathogen responsible for the ulcus molle. The ulcus molle pathogen can usually already be identified under the microscope.
To further confirm the diagnosis, a pathogen culture is then created to cultivate the bacteria. The reason for this is the risk of confusion with other diseases with similar symptoms, such as
Laboratory detection of the ulcus molle pathogen therefore also serves to rule out other pathogens.
In the case of ulcus molle, the sexual partner must also be treated © Khunatorn | AdobeStock
Ulcus molle is usually treated with antibiotics that specifically combat the bacterial pathogens. In particular, the antibiotic erythromycin is available. The patient must take it daily for 7 days. The antibiotic ciprofloxacin also helps. It is sufficient to take it daily for three days.
In addition, the broken ulcers should be cleaned regularly and kept dry.
Ulcus molle therapy can only be successful if the sexual partner of the affected person is also treated. Otherwise a cycle will develop in which the partners repeatedly infect each other.
You must refrain from sexual intercourse until you are completely cured.
With early and consistent treatment of ulcus molle, the ulcers and the bacterial infection usually heal without consequences. Painful lymph nodes then do not appear in the first place.
But even if treatment is started later, the chances of healing are very good.
