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Chancroid - Causes, Symptoms and Treatment

Chancroid Definition:

Chancroid is a sexually transmitted disease caused by infection with the bacterium Haemophilus ducreyi. This organism causes one or more ulcers on the genitalia and are associated with inguinal lymphadenitis. The affected lymph nodes may progress towards the formation of abscess. Co-existent infection with other organisms such as herpes simplex, treponema pallidum and chlamydia trachomatis is also very common.

The size of chancroid infection usually varies from 1-2 millimeters to several centimeters but is usually 1-2 centimeters in diameter. It's shape can be irregular, oval or round.

Chancroid Causes

Chancroid results from Haemophilus ducreyi, a gram-negative streptobacillus, and is most commonly spread by sexual contact with an individual already infected with chancroid. The bacteria are more likely to invade the sexual organs at the point of a pre-existing injury, such as a small cut or scratch. The likelihood of transmission is greater if a person is very active sexually and does not practice personal hygiene.

The disease is found primarily in developing countries. Only a few hundred cases a year are diagnosed in the United States. The majority of individuals in the U.S. diagnosed with chancroid have traveled outside the country to areas where the disease is known to occur frequently. Uncircumcised men are at much higher risk than circumcised men for contracting chancroid from an infected partner. Chancroid is a risk factor for contracting the HIV virus.

Chancroid Symptoms

The incubation period (the time in which we start to see the symptoms of chancroid infection after contact with a infected partner) is typically varying between 3 to 5 days (usually 2-3 days). The ulcer usually begins as a tender, elevated bump, or papule, that becomes a pus-filled open sore with eroded or ragged edges.

The first sign of infection is usually the appearance of one or more sores or raised bumps on the genital organs. The overlying skin may become red and warm, indicating that the gland is infected, filled with pus, and has formed an abscess. In some cases, the infection opens through the skin, draining the abscess. 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.

In 50 percent of the untreated cases, the chancroid bacteria infects the lymph nodes in the groin. In about five to ten 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. The ulcers can be very painful in men but women are often unaware of them.

Some other Symptoms of chancroid may include:

  • painful bowel movements.
  • painful ulcers, which may drain pus.
  • painful urination.
  • rectal bleeding.
  • swollen lymph nodes.
  • vaginal discharge.

Chancroid Treatment

Chancroid is a bacterial disease causing painful, irregularly shaped sores, but is a localized infection which can be treated and cured and has no long-term effects. A successful treatment can:

  • cure infection.
  • resolve symptoms.
  • prevent any further transmission.

The infection is treated with appropriate antibiotics. Some of the most effective antibiotics used for curing chancroid include - azithromycin, ceftriaxone, ciprofloxacin (not recommended for pregnant or nursing females, or people younger than 18 years.) and erythromycin. The safety of azithromycin for pregnant or lactating women has not been established. Aspiration of fluid-filled nodes helps prevent spreading the infection. Large lymph node swellings need drainage either by needle or local surgery.

Chancroid has become resistant to penicillin and tetracycline. Regular doses of erythromycin, trimethoprin, or ciprofloxacin are given for up to 2 weeks. Alternatively, azithromycin or ceftriaxone may be given in a single dose. A follow-up examination is typically required 7 days after starting treatment. Healing usually takes 10 to 11 days, but may take 2 weeks. Buboes may need to be drained with a needle (aspirated) under local anesthesia and scarring may occur from those that burst on their own.

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