Chancroid

Chancroid
Chancroid
Classification and external resources

Photomicrograph of H. ducreyi
ICD-10 A57
ICD-9 099.0
DiseasesDB 5563
MedlinePlus 000635
eMedicine emerg/95
MeSH D002602

Chancroid (also known as soft chancre[1]:274 and "ulcus molle"[2]) is a sexually transmitted infection characterized by painful sores on the genitalia. Chancroid is known to be spread from one individual to another solely through sexual contact.

Contents

Symptoms and signs

After an incubation period of one day to two weeks, chancroid begins with a small bump that becomes an ulcer within a day of its appearance. The ulcer characteristically:

  • Ranges in size dramatically from 3 to 50 mm (1/8 inch to two inches) across
  • Is painful
  • Has sharply defined, undermined borders
  • Has irregular or ragged borders
  • Has a base that is covered with a gray or yellowish-gray material
  • Has a base that bleeds easily if traumatized or scraped

In more specific terms, the CDC's standard clinical definition for a probable case of chancroid includes all of the following:

  • Patient has one or more painful genital ulcers. The combination of a painful ulcer with tender adenopathy is suggestive of chancroid; the presence of suppurative adenopathy is almost pathognomonic.
  • No evidence of Treponema pallidum is indicated by dark-field examination of ulcer or by a serologic test for Syphilis performed at least 7 days after the onset of ulcer.
  • The clinical presentation is not typical of disease caused by human herpesvirus 2 (Herpes Simplex Virus), or result of culture for HSV is negative.

About half of infected men have only a single ulcer. Women frequently have four or more ulcers, with fewer symptoms. The ulcers appear in specific locations, such as the coronal sulcus of the uncircumcised glans penis in men, or the fourchette and labia minora in women.

Common locations in women

In women, the most common location for ulcers is the labia majora. "Kissing ulcers" may develop. These are ulcers that occur on opposing surfaces of the labia. Other areas such as the labia minora, perineal area, and inner thighs may also be involved. The most common symptoms in women are dysuria (pain with urination) and dyspareunia (pain with intercourse).

The initial ulcer may be mistaken as a "hard" chancre, the typical sore of primary syphilis, as opposed to the "soft chancre" of chancroid.

Approximately one-third of the infected individuals will develop enlargements of the inguinal lymph nodes, the nodes located in the fold between the leg and the lower abdomen.

Half of those who develop swelling of the inguinal lymph nodes will progress to a point where the nodes rupture through the skin, producing draining abscesses. The swollen lymph nodes and abscesses are often referred to as buboes.

Causes

Chancroid is a bacterial infection caused by the fastidious Gram-negative streptobacillus Haemophilus ducreyi. It is a disease found primarily in developing countries, most prevalent in low socioeconomic groups, associated with commercial sex workers.

Infection levels are low in the Western world, typically around one case per two million of the population (Canada, France, Australia, UK and US).[citation needed] Most individuals diagnosed with chancroid have visited countries or areas where the disease is known to occur frequently, although outbreaks have been observed in association with crack cocaine use and prostitution.[citation needed]

Chancroid is a risk factor for contracting HIV, due to their ecological association or shared risk of exposure, and biologically facilitated transmission of one infection by the other.

Treatment

The CDC recommendation for chancroid is a single oral dose (1 gram) of Azithromycin or a single IM dose of Ceftriaxone or oral Erythromycin for seven days.

Comparison with syphilis

There are many differences and similarities between the conditions syphilitic chancre and chancroid (reference 1 and 2)

Similarities
  • Both originate as pustules at the site of inoculation, and progress to ulcerated lesions
  • Both lesions are typically 1–2 cm in diameter
  • Both lesions are caused by sexually transmissible organisms
  • Both lesions typically appear on the genitals of infected individuals
  • Both lesions can present at multiple sites and with multiple lesions
Differences
  • Chancre is a lesion typical of infection with the bacterium that causes syphilis, Treponema pallidum
  • Chancroid is a lesion typical of infection with the bacterium Haemophilus ducreyi
  • Chancres are typically painless, whereas chancroid are typically painful
  • Chancres are typically non-exudative, whereas chancroid typically have a grey or yellow purulent exudate
  • Chancres have a hard (indurated) edge, whereas chancroid have a soft edge
  • Chancres heal spontaneously within three to six weeks, even in the absence of treatment
  • Chancres can occur in the pharynx as well as on the genitals

External links

Notes

  1. ^ James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0. 
  2. ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 1-4160-2999-0. 

References

  1. http://www.utdol.com/online/content/topic.do?topicKey=stds/7330
  2. http://www.utdol.com/online/content/topic.do?topicKey=stds/3050&selectedTitle=1~28&source=search_result

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Look at other dictionaries:

  • Chancroid — Chan croid, n. [Chancre + oil.] (Med.) A venereal sore, resembling a chancre in its seat and some external characters, but differing from it in being the starting point of a purely local process and never of a systemic disease; called also {soft… …   The Collaborative International Dictionary of English

  • chancroid — [shaŋ′kroid΄] n. [ CHANCR(E) + OID] an infectious venereal ulcer, usually on or about the genitals, caused by a bacterium (Hemophilus ducreyi); soft chancre …   English World dictionary

  • chancroid — (shang kroid) A sexually transmitted disease caused by the gram negative bacterium Haemophilus ducreyi. Worldwide, chancroid is an important cofactor in the transmission of the AIDS virus. Also known as genital ulcer disease due to the painful… …   Dictionary of microbiology

  • chancroid — An infectious, painful, ragged venereal ulcer at the site of infection by Haemophilus ducreyi, beginning after an incubation period of 3–7 days; seen more commonly in men; Gram negative streptobacilli may be identified by staining material from… …   Medical dictionary

  • chancroid ulcer — chancroid …   Medical dictionary

  • chancroid — /ˈʃæŋkrɔɪd/ (say shangkroyd) Pathology –noun 1. a soft, non syphilitic venereal sore. 2. the causative organism, Haemophilus ducreyi. –adjective 3. of, relating to, or resembling a chancroid or chancre …  

  • chancroid — noun Date: 1861 a venereal disease caused by a bacterium (Hemophilus ducreyi) and characterized by chancres unlike those of syphilis in lacking firm indurated margins called also soft chancre • chancroidal adjective …   New Collegiate Dictionary

  • chancroid — chancroidal, adj. /shang kroyd/, n. Pathol. an infectious venereal ulcer with a soft base. Also called simple chancre, soft chancre. [1860 65; CHANCRE + OID] * * * ▪ pathology       acute, localized, chiefly sexually transmitted disease, usually… …   Universalium

  • chancroid — noun a) A sexually transmitted infection characterized by painful sores on the genitalia. b) A sore characteristic of this infection …   Wiktionary

  • chancroid — n. type of ulcer or sore …   English contemporary dictionary

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