Differential Diagnosis for Penile Lesions
Single Most Likely Diagnosis
- Herpes Simplex Virus (HSV) Infection: The patient has a reactive HSV 1 IGG, indicating a past or current infection. The presence of penile lesions is consistent with genital herpes, which is a common cause of such symptoms.
Other Likely Diagnoses
- Syphilis: Although the treponema pallidum antibody is negative, the RPR Titer 1:1 suggests a possible false-negative result or early infection. Syphilis can cause penile lesions, and the RPR test is often used as a screening tool.
- Other Sexually Transmitted Infections (STIs): The patient's symptoms and lab results suggest a possible STI. Other common causes of penile lesions include chlamydia, gonorrhea, and human papillomavirus (HPV).
Do Not Miss Diagnoses
- Cancer (e.g., Squamous Cell Carcinoma): Although rare, penile cancer can present with lesions. It is essential to consider this diagnosis to ensure prompt treatment and prevent serious consequences.
- Lymphogranuloma Venereum (LGV): This STI can cause penile lesions and is often associated with other symptoms like lymphadenopathy. LGV is a rare but important diagnosis to consider due to its potential for serious complications.
Rare Diagnoses
- Behçet's Disease: This rare condition can cause genital ulcers, including penile lesions. Although unlikely, it is essential to consider this diagnosis in patients with recurrent or atypical lesions.
- Granuloma Inguinale: This rare STI can cause penile lesions and is often associated with other symptoms like lymphadenopathy. Granuloma inguinale is a rare but important diagnosis to consider due to its potential for serious complications.