Měkký vřed (Ulcus molle)
Pohlavní nemoc postihující nejčastěji muže - homosexuály
Měkký vřed, jinak známý také jako chankroid, je pohlavně přenosná choroba, kterou charakterizuje výskyt vředů na genitálu a abscesů v oblasti třísel. Původcem nemoci je bakterie Haemophilus ducrei, tyčinkovitý parazit citlivý na zvýšenou teplotu a vyschnutí. Onemocnění měkký vřed pravděpodobně přenáší ženy. Muži, především homosexuálové, podléhají nákaze častěji, většinou se u nich vředy objevují na žaludu, předkožce a uzdičce. Pouze výjimečně jsou kromě genitálií zasažena jiná místa jako prsty, rty nebo mandle.
Stejně jako obdobné dermatovenerologické choroby podstatně zvyšuje riziko přenosu viru HIV. Vyskytuje se především v tropech, ale onemocnění se rozšiřuje i v USA a Evropě.
Sexuálně přenosná choroba podléhá ohlašovací povinnosti. Díky tomu víme, že v České republice se toto onemocnění již několik let neobjevilo, což však při vysoké migraci v globalizovaném světě není příliš podstatné.
Měkký vřed příznaky nemoci
Inkubační doba trvá 4 – 7 dní. Poté se objeví potíže při močení a malý bolestivý vřídek (vřídky) na zevním genitálu. Nehojí se jako běžný vřídek, naopak se z něj stává mokvající bolák. Vřed má podminované okraje, postrádá tuhou zatvrdlou spodinu (proto název měkký vřed), která při stisknutí nebo tření lehce krvácí. Vřed lemuje červená linka. Do velikosti cca 1,5 centimetru už neroste, ale začíná se hojit jizvou.
Pokud se včas nezahájí léčba, mohou se vředy spojit a rozrůst se do velkých a bolestivých ložisek a přesunout infekci do lymfatických uzlin v oblasti třísel. Posuvná kůže normální barvy nad uzlinami zarudne, vyhladí se a změní svůj povrch na lesklý. Pokročilým stadiem nemoci je bolestivé zduření mízních uzlin – tzv. bubony, jejich prasknutí a vytvoření píštěle, z níž vytéká žlutozelený hnis zbarvený krví. Dutina se po provalení uzliny hojí vtaženou jizvou.
U žen jsou bubony spíše výjimečné.
Léčba měkkého vředu
Léčba spočívá v podávání antibiotik. Diagnózu lze často určit pouhým prohlédnutím postiženého místa, ale venerolog by měl vždy učinit mikroskopický rozbor hnisu, aby se vyloučil syfilis.
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Má s tím někdo zkušenosti? je to bolestivé?
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