Detection of Treponema pallidum, Haemophilus ducreyi, and Herpes Simplex Virus by Multiplex PCR.

The three major causes of genital ulcer disease (GUD) are herpes simplex virus (HSV), Treponema pallidum, and Haemophilus ducreyi. Although techniques exist for the laboratory diagnosis of all three organisms, constraints of cost, availability of equipment and expertise, and the lack of sensitivity and specificity of available tests, result in clinical presentation being primarily used for the diagnosis of GUD both in the United States and in developing countries. Due to the overlapping clinical presentation of the three diseases caused by these etiologic agents, and due to coinfection, these diseases are often misdiagnosed (1). It is now recognized that not only is GUD a cofactor in HIV transmission, but also that treatment of sexually transmitted diseases can reduce the incidence of HIV (2-4), thus efficient and early diagnosis and treatment of GUD is of utmost importance.