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Microbiology Bacteria b1e46e1c

A man who has a penile chancre appears in a hospital's emergency service. The VDRL test is negative. The most appropriate course of action for the physician in charge would be to

A
Send the patient home untreated
B
Repeat the VDRL test in 10 days
C
Perform dark-field microscopy for treponemes
D
Swab the chancre and culture on Thayer-Martin agar
High-Yield Explanation
In men, the appearance of a hard chancre on the penis characteristically indicates syphilis. Even though the chancre does not appear until the infection is 2 or more weeks old, the VDRL test for syphilis still can be negative despite the presence of a chancre (the VDRL test may not become positive for 2 or 3 weeks after initial infection). However, a lesion suspected of being a primary syphilitic ulcer should be examined by dark-field microscopy, which can reveal motile treponemes.

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