Chancroid

Chancroid (or soft chancre) is a sexually transmitted disease characterized by painful genital ulcers and inguinal adenitis.

Chancroid is a common cause of genital ulcers in developing countries. The infection is on the rise in the United States and is associated with increased risk for human immunodeficiency virus (HIV) infection. It affects males more often than females.

The incubation period varies but typically ranges from 5 to 7 days. Chancroidal lesions may heal spontaneously and usually respond well to treatment when no secondary infections are present.

Causes

Chancroid results from Haemophilus ducreyi, a short, nonmotile, gram-negative bacillus. Poor personal hygiene may predispose men - especially those who are uncircumcised - to this disease.

Signs and Symptoms

The first sign of infection is usually the appearance of one or more sores or raised bumps on the genital organs. They are surrounded by a narrow red border which soon becomes filled with pus and eventually ruptures, leaving a painful open sore. In 50 percent of untreated cases, the chancroid bacteria infect the lymph nodes in the groin. Within 5 to 10 days of the appearance of primary sores, the glands on one side (or both sides) of the groin become enlarged, hard and painful and may eventually rupture.

Diagnostic tests

A definite diagnosis requires culture of Haemophilus ducreyi . This needs a special culture media that is not widely available. A probable diagnosis can be made if the clinical features are typical and other causes of genital ulceration, particularly syphilis and herpes simplex have been ruled out. Other tests such as PCR are not routinely available.

Genital ulcer disease e.g. chancroid or syphilis, increases the risk of HIV infection so HIV testing should be undertaken as well.

Treatment

Ceftriaxone can be given 250 mg as a single intramuscular dose. Oral dosing with erythromycin, trimethoprim-sulfamethoxazole, or ciprofloxacin is also effective.

Aspiration of fluid-filled nodes and careful personal hygiene help prevent the infection from spreading.

Sexual activity should not take place until all the lesions have completely healed. Untreated ulcers may persist for 1-3 months.

Prevention

Chancroid is a bacterial infection that is spread by sexual contact with other infected individuals. Although abstinence is the only sure prevention, safe sex practices are helpful in preventing the spread of chancroid.

Monogamous sexual relations with a known disease-free partner is the safest and most practical "safe sex" method. Condoms provide very good protection from the spread of most sexually transmitted diseases when used properly and consistently.