Intensive Care Medicine (ICM) Practice Exam

Which condition can present as a painful ulcer with no vesicular lesions?

1. Syphilis

2. Herpes Simplex Virus infection

3. Chancroid

4. HPV infection

The correct answer is: Chancroid

A painful ulcer without vesicular lesions commonly indicates the presence of chancroid, an infection caused by the bacterium Haemophilus ducreyi. Chancroid is characterized by the formation of soft, painful ulcers that can become quite large and are often accompanied by painful, swollen regional lymph nodes. Unlike herpes simplex virus infection, which typically presents with vesicular lesions followed by ulceration, chancroid does not present with vesicles. Syphilis can also lead to ulcers, but these are usually painless and manifest as a solitary sore called a chancre in its primary stage. HPV infection primarily leads to warts and does not present as painful ulcers. In summary, the defining characteristics of chancroid—painful ulcers with the absence of vesicles—clearly differentiate it from the other conditions listed.