••• Chapter 30^ Genital Tract Infections and PID^291
❍ What are the three most prevalent primary viral infections of the vulva?
Herpes genitalis, condyloma acuminatum, and molluscum contagiosum.
❍ What are some treatments of choice for recurrent Bartholin duct cyst or abscess?
Insertion of the Word Catheter or marsupialization of the Bartholin duct cyst.
❍ What is the organism responsible for syphilis?
The spirochete Treponema pallidum.
❍ In pregnant patients with penicillin allergies, what is the treatment of syphilis?
Desensitization protocol and then treat with penicillin.
❍ What are the confirmatory tests for syphilis?
The fluorescent treponemal antibody absorption (FTA-ABS) or microhemagglutination assay for antibodies to
T. pallidum (MHA-TP). The Venereal Disease Research Laboratories (VDRL) or rapid plasma reagin (RPR) are
nonspecific and are only used for screening.
❍ What test is used to monitor successful treatment of syphilis?
RPR titers decreasing.
❍ What is the classic skin lesion of primary syphilis?
It is the chancre, a firm, painless ulcer that develops at a mucus or cutaneous site of entry of the spirochete.
❍ When does a serologic test for syphilis become positive after exposure?
Generally 4 to 6 weeks after exposure.
❍ What percentage of women with primary herpes experienced systemic symptoms?
70%. Primary herpes is much more severe than recurrent infection.
❍ How long can viral shedding occur after herpetic vulvar lesions appear?
Up to 2 to 3 weeks.
❍ What is the benefit of acyclovir in the treatment of genital herpes?
It reduces the duration of ulcerative lesions and the median duration of viral shedding, and decreases the
recurrence rate when given prophylactically.
❍ What is the pathognomonic microscopic finding of granuloma inguinale?
Donovan bodies, which are clusters of dark staining, bipolar-appearing bacteria in large mononuclear cells.
❍ What is lymphogranuloma venereum (LGV)?
A chronic infection of lymphatic tissue produced by Chlamydia trachomatis, serotypes L1, L2, or L3.