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What is chancroid?
Chancroid is a highly contagious yet curable sexually transmitted disease (STD) caused by the bacteria Haemophilus ducreyi . Chancroid causes ulcers, usually of the genitals. Swollen, painful lymph glands, or inguinal buboes , in the groin area are often associated with chancroid. Left untreated, chancroid may facilitate the transmission of HIV.
How common is it?
The prevalence of chancroid has declined in the United States. When infection does occur, it is usually associated with sporadic outbreaks. Worldwide, chancroid appears to have declined as well, although infection might still occur in some regions of Africa and the Caribbean. Chancroid, as well as genital herpes and syphilis, is a risk factor in the transmission of HIV infection.
A definitive diagnosis of chancroid requires the identification of H. ducreyi on special culture media that is not widely available from commercial sources; even when these media are used, sensitivity is less than 80 percent. No FDA-cleared PCR test for H. ducreyi is available in the United States, but such testing can be performed by clinical laboratories that have developed their own PCR test and have conducted a CLIA verification study.
The combination of a painful genital ulcer and tender suppurative inguinal adenopathy suggests the diagnosis of chancroid. A probable diagnosis of chancroid, for both clinical and surveillance purposes, can be made if all of the following criteria are met: 1) the patient has one or more painful genital ulcers; 2) the patient has no evidence of T. pallidum infection by darkfield examination of ulcer exudate or by a serologic test for syphilis performed at least seven days after onset of ulcers; 3) the clinical presentation, appearance of genital ulcers and, if present, regional lymphadenopathy are typical for chancroid; and 4) a test for HSV performed on the ulcer exudate is negative.
How do people get chancroid?
Chancroid is transmitted in two ways:
sexual transmission through skin-to-skin contact with open sore(s).
non-sexual transmission when pus-like fluid from the ulcer is moved to other parts of the body or to another person.
A person is considered to be infectious when ulcers are present. There has been no reported disease in infants born to women with active chancroid at time of delivery.
What are the signs or symptoms of chancroid?
Symptoms usually occur within four days to ten days from exposure. They rarely develop earlier than three days or later than ten days.
The ulcer begins as a tender, elevated bump, or papule, that becomes a pus-filled, open sore with eroded or ragged edges.
The ulcer is soft to the touch (unlike a syphilis chancre that is hard or rubbery). The term soft chancre is frequently used to describe the chancroid sore.
The ulcers can be very painful in men but women are often unaware of them.
Because chancroid is often asymptomatic in women, they may be unaware of the lesion(s).
Painful lymph glands may occur in the groin, usually only on one side; however, they can occur on both sides.
How is chancroid diagnosed?
Diagnosis is made by isolating the bacteria Hemophilus ducreyi in a culture from a genital ulcer. The chancre is often confused with syphilis, herpes or lymphogranuloma venereum; therefore, it is important that your health care provider rule these diseases out.
A Gram stain to identify H. ducreyi is possible but can be misleading because of other organisms found in most genital ulcers.
What is the treatment for chancroid?
Successful treatment for chancroid cures the infection, resolves the clinical symptoms, and prevents transmission to others. In advanced cases, scarring can result, despite successful therapy.
Antibiotics used to treat chancroid include; Azithromycin 1 g orally, Ceftriaxone 250 mg intramuscularly (IM), Ciprofloxacin 500 mg orally or Erythromycin 500 mg orally.
Ciprofloxacin is contraindicated for pregnent and lactating women.
Azithomycin and ceftriaxone offer the advantage of single-dose therapy. Worldwide, several isolates with intermediate resistance to either ciprofloxacin or erythromycin have been reported. However, because cultures are not routinely performed, data are limited regarding the current prevalence of antimicrobial resistance.
Abstinence (not having sex)
Mutual monogamy [having sex with only one uninfected partner]
Latex condoms for vaginal, oral and anal sex. Using latex condoms may protect the penis or vagina from infection, but does not protect other areas such as the scrotum or anal area. Chancroid lesions can occur in genital areas that are covered or protected by a latex condom, but may occur in areas that are not covered or protected by a condom. Latex condoms, when used consistently and correctly, can reduce the risk of chancroid, genital herpes, syphilis, and genital warts, only when the infected areas are covered or protected by the condom.
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Chancroid is a highly contagious yet curable sexually transmitted disease (STD) caused by the bacteria Haemophilus ducreyi . Chancroid causes ulcers, usually of the genitals. Swollen, painful lymph glands, or inguinal buboes , in the groin area are often associated with chancroid. Left untreated, chancroid may facilitate the transmission of HIV.
How common is it?
The prevalence of chancroid has declined in the United States. When infection does occur, it is usually associated with sporadic outbreaks. Worldwide, chancroid appears to have declined as well, although infection might still occur in some regions of Africa and the Caribbean. Chancroid, as well as genital herpes and syphilis, is a risk factor in the transmission of HIV infection.
A definitive diagnosis of chancroid requires the identification of H. ducreyi on special culture media that is not widely available from commercial sources; even when these media are used, sensitivity is less than 80 percent. No FDA-cleared PCR test for H. ducreyi is available in the United States, but such testing can be performed by clinical laboratories that have developed their own PCR test and have conducted a CLIA verification study.
The combination of a painful genital ulcer and tender suppurative inguinal adenopathy suggests the diagnosis of chancroid. A probable diagnosis of chancroid, for both clinical and surveillance purposes, can be made if all of the following criteria are met: 1) the patient has one or more painful genital ulcers; 2) the patient has no evidence of T. pallidum infection by darkfield examination of ulcer exudate or by a serologic test for syphilis performed at least seven days after onset of ulcers; 3) the clinical presentation, appearance of genital ulcers and, if present, regional lymphadenopathy are typical for chancroid; and 4) a test for HSV performed on the ulcer exudate is negative.
How do people get chancroid?
Chancroid is transmitted in two ways:
sexual transmission through skin-to-skin contact with open sore(s).
non-sexual transmission when pus-like fluid from the ulcer is moved to other parts of the body or to another person.
A person is considered to be infectious when ulcers are present. There has been no reported disease in infants born to women with active chancroid at time of delivery.
What are the signs or symptoms of chancroid?
Symptoms usually occur within four days to ten days from exposure. They rarely develop earlier than three days or later than ten days.
The ulcer begins as a tender, elevated bump, or papule, that becomes a pus-filled, open sore with eroded or ragged edges.
The ulcer is soft to the touch (unlike a syphilis chancre that is hard or rubbery). The term soft chancre is frequently used to describe the chancroid sore.
The ulcers can be very painful in men but women are often unaware of them.
Because chancroid is often asymptomatic in women, they may be unaware of the lesion(s).
Painful lymph glands may occur in the groin, usually only on one side; however, they can occur on both sides.
How is chancroid diagnosed?
Diagnosis is made by isolating the bacteria Hemophilus ducreyi in a culture from a genital ulcer. The chancre is often confused with syphilis, herpes or lymphogranuloma venereum; therefore, it is important that your health care provider rule these diseases out.
A Gram stain to identify H. ducreyi is possible but can be misleading because of other organisms found in most genital ulcers.
What is the treatment for chancroid?
Successful treatment for chancroid cures the infection, resolves the clinical symptoms, and prevents transmission to others. In advanced cases, scarring can result, despite successful therapy.
Antibiotics used to treat chancroid include; Azithromycin 1 g orally, Ceftriaxone 250 mg intramuscularly (IM), Ciprofloxacin 500 mg orally or Erythromycin 500 mg orally.
Ciprofloxacin is contraindicated for pregnent and lactating women.
Azithomycin and ceftriaxone offer the advantage of single-dose therapy. Worldwide, several isolates with intermediate resistance to either ciprofloxacin or erythromycin have been reported. However, because cultures are not routinely performed, data are limited regarding the current prevalence of antimicrobial resistance.
Abstinence (not having sex)
Mutual monogamy [having sex with only one uninfected partner]
Latex condoms for vaginal, oral and anal sex. Using latex condoms may protect the penis or vagina from infection, but does not protect other areas such as the scrotum or anal area. Chancroid lesions can occur in genital areas that are covered or protected by a latex condom, but may occur in areas that are not covered or protected by a condom. Latex condoms, when used consistently and correctly, can reduce the risk of chancroid, genital herpes, syphilis, and genital warts, only when the infected areas are covered or protected by the condom.
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