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Chancroid

Definition

Chancroid is a sexually transmitted infection (STI) caused by the bacterium Haemophilus ducreyi.

What is going on in the body?

Chancroid is a relatively uncommon STI that is spread from one person to another through vaginal, anal, or oral sex.
About 3 to 10 days after exposure, a newly infected person will develop a tender, red bump on the genitals. This bump, known as a bubo, will evolve into a painful ulcer over the next 2 days. Over half of individuals with chancroid have more than one ulcer.

Risks

What are the causes and risks of the infection?

Chancroid is a sexually transmitted infection. Risky sexual behaviors, such as having more than one partner, increase the risk for chancroid.
Many more cases are reported among men than among women. This may be because some transmission occurs among men who have sex with men, or because compared to other STIs, the infection is concentrated among female prostitutes and their consorts - a situation in which one woman can infect several men.
Individuals with immunodeficiency disorders, such as HIV, are at higher risk for chancroid.

Prevention

What can be done to prevent the infection?

Safer sex methods such as the use of male or female condoms can reduce, but not eliminate, the risk of chancroid. Anyone diagnosed with chancroid should encourage his or her sexual partners to be tested and treated.

Diagnosed

How is the infection diagnosed?

Diagnosis of chancroid begins with a medical history and physical exam. The following three criteria point to a diagnosis of chancroid:
  • The person has one or more painful ulcers, which may be associated with swollen lymph nodes.
  • Syphilis has been ruled out with diagnostic tests.
  • The person's symptoms are not typical of genital herpes, or a culture for the herpes virus is negative.
The Haemophilus ducreyi bacteria that cause chancroid can only be grown on a special culture medium at a lower temperature than most other bacterial cultures. The sensitivity of the test varies depending on the laboratory.
Polymerase chain reaction (PCR) is a more sensitive diagnostic test, but usually the specimen would have to be shipped to a reference laboratory, imposing a delay in the diagnosis.

Long Term Effects

What are the long-term effects of the infection?

Chancroid occasionally causes long-term effects, such as tightening of the foreskin on a man's penis. Occasionally, there may be permanent scarring at the site of an ulcer.

Other Risks

What are the risks to others?

Chancroid is a sexually transmitted infection. It can be spread through vaginal, oral, or anal intercourse even before an ulcer is noticed.

Treatments

What are the treatments for the infection?

Antibiotics are used to treat chancroid. These include azithromycin (i.e., Zithromax, Zmax), ceftriaxone (i.e., Rocephin), erythromycin, and ciprofloxacin (i.e., Cipro).

Side Effects

What are the side effects of the treatments?

Antibiotics may cause stomach upset, rash, or allergic reactions.

After Treatment

What happens after treatment for the infection?

Improvement occurs within days of starting treatment. It is usually complete after 2 weeks. Relapse sometimes occurs but will usually respond to a second course of antibiotics. A person with chancroid also should be tested for other STIs and treated as needed.

Monitor

How is the infection monitored?

Any new or worsening symptoms should be reported to the healthcare professional.

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