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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 is a sexually-transmitted infection caused by the Gram negative bacterium Haemophilus ducreyi . The main symptom is genital sores that rupture after a few days.

The disease is found primarily in developing and third world countries. Only a few hundred cases a year are diagnosed in the U.S. 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.

Symptoms and Signs

Within three to seven days of exposure, one or more small bumps will form on or near the genitals. Within a day these bumps will become painful open sores, ranging in size from an eighth of an inch to 2 inches in diameter. Many people also experience achingly swollen lymph glands in the groin. Sometimes this swelling continues until the lymph nodes rupture through the skin and form abscesses called buboes. Some women don't develop sores, but experience other symptoms such as soreness during urination or defecation, vaginal discharge, severely painful intercourse, or rectal bleeding.

Diagnostic tests

Cultures from the lesion are necessary to confirm diagnosis.

Dark-field examination and serologic testing rule out other sexually transmitted diseases (genital herpes, syphilis, lymphogranuloma venereum) that cause similar ulcers.

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.

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.

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