Chancroid

CHANCROID:
  • Chancroid is a sexually transmitted infection caused by the bacteria Haemophilus ducreyi.
  • Incubation period of chancroid is < 7 days.
  • Most people with chancroid will develop one or more red, inflamed lumps in the genital area 3-7 days after being infected during sexual intercourse. These become larger and pus-filled until they rupture, leaving a painful ulcer.
  • If left untreated, 50% of cases develop infected lymph glands, which become large, hard painful lumps (buboes), on either one or both sides of the groin. The site of most infections in men is the foreskin but other parts of the penis may be affected.
  • In women, ulcers may be located on the labia, thigh, perineum and cervix.
  • Women generally have less specific symptoms such as painful urination or pain on passing bowel motions (defaecation), vaginal discharge, painful sexual intercourse (dyspareunia) and rectal bleeding.
Diagnosis:
  • Based on history: sexual exposure with infected person, short incubation period & morphology.
  • Confirmed by demonstration of organisms from smears taken from bubo.
  • Smears are stained with gram's or Pappenheim's stain.
  • Ito-Reenstierna intradermal test: becomes positive 1 or 2 weeks after appearance of sore & persists positive for life.
  • Injection of 0.1ml of suspension of killed organism & inferred as positive if a nodule of > 5mm appears after 24 hours.
Treatment:
  • Erythromycin & Ceftriaxone.
Exam Question
  • Chancroid is caused by H.Ducreyi.
  • DOC in chancroid is Erythromycin.
  • Reliable test for chancroid detection is Grams stained smear.
  • Chancroid may be caused by Herpes virus - hominis.
  • Incubation period of chancroid is < 7 days.
  • Syndromic Management of genital ulcer syndrome in India includes Chancroid, Primary Chancre and herpes simplex 
  • Painful lymphadenopathy may be seen in Chancroid.Tender Bubos seen are used in the diagnosis of Chancroid.
  • A man having multiple, painful, indurated, undermined, sloughed edged glans which occurred 5 days after exposures; most likely diagnosis is Chancroid. Ito's test is used in the diagnosis of Chancroid
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