Chancroid

Bacterial Vaginosis : Background Bacterial Vaginosis : Treatment
Bacterial Vaginosis : Risk Factors Bacterial Vaginosis : Prevention
Bacterial Vaginosis : Signs and Symptoms Bacterial Vaginosis : Prognosis
Bacterial Vaginosis : Complications Bacterial Vaginosis : References
Bacterial Vaginosis : Diagnosis

Background

ChancroidChancroid is a sexually transmitted infection characterized by open sores on the genitals. It is caused by a bacteria called Haemophilus ducreyi. It was once common in the United States, but is now very rare. However, the infection still occurs in less-developed and third world countries.

Chancroid is transmitted from person to person through sexual contact. Actual intercourse is not necessary – the infection can be spread by any skin-to-skin genital contact. People can also spread chancroid from one part of the body to another by touching the open sores.

According to The Centers for Disease Control (CDC), only 15 new cases were reported in the United States in 2012. In most cases, these cases involved a person who had travelled outside of the country to an area where the infection is more common. However, since Haemophilus ducreyi is difficult to culture and sometimes goes away without treatment, the condition may be significantly underdiagnosed.

Risk Factors

Chancroid is most common in less-developed and third world countries in Asia, Africa and the Caribbean. It is especially prevalent among men who have frequent contact with prostitutes.

An uncircumcised man has a higher risk of becoming infected, since the foreskin on the penis may conceal sores and promote the spread of bacteria.

People who have other sexually transmitted infections such as HIV are more likely to have chancroid.

Signs and Symptoms

Symptoms of chancroid usually occur 4-10 days after exposure. The initial symptom is a small tender bump in the genitals. Within a day, the bump becomes an open sore (ulcer). The sore is usually soft, painful, and greyish or yellowish grey in color. It bleeds easily if bumped or scraped and may be pus filled. About half of men have only a single sore, while most women have four or more sores. About half of men and women also experience swollen lymph glands in the groin.

In men, the sores typically appear on the head of the penis, shaft of the penis, groove behind the head of the penis, or foreskin. In women, the sores typically appear on the outer lips of the vagina (labia), near the clitoris, or in the perineal area (area between the genitals and anus). Sometimes, the sores spread to the scrotum, rectum, anus, and thighs. Anal sores may bleed and cause painful bowel movements. Pain may also occur during sexual intercourse and urination. Some people feel mildly ill with a moderate fever and lack of energy.

Complications

In most cases, chancroid does not cause other health problems. However, it can sometimes lead to fistulas and scars on the foreskin of the penis in uncircumcised males.

In men and women with swollen lymph nodes, the nodes can break through the skin and cause larges abscesses. It may be necessary to drain the abscesses with a needle or with local surgery. Light scarring may occur.

Chancroid may increase the risk of contracting HIV (the virus that causes AIDS). This is because open sores on the genitals make it easier for the HIV virus to enter the body.
In addition, chancroid in persons with HIV can take much longer to heal.

Diagnosis

After you describe your symptoms, your health care provider will do a pelvic examination, inspecting the sores and checking for enlarged lymph nodes. Usually, a fluid sample is taken from a fresh sore and sent to a laboratory for analysis.

There is no blood test for chancroid, since the bacteria do not enter the bloodstream. However, a blood test is often done to rule out or identify other STDs, including syphilis and genital herpes.

Treatment

Chancroid will sometimes clear up on its own without treatment. However, getting treatment is important to avoid recurrences and to reduce the likelihood of scarring.

Chancroid can be treated effectively with antibiotics including erythromycin, ciprofloxacin, azithromycin, and ceftriaxone. Erythromycin and ciprofloxacin are taken orally for up to 2 weeks. Azithromycin and ceftriaxone may be given in a single dose. Azithromycin is taken orally and ceftriaxone is given as an intramuscular injection. Ceftriaxone is the treatment of choice among pregnant women.

Chancroid usually clears up in 10 to 11 days with antibiotics, but it is important to take all of the medicine prescribed to you even if your symptoms disappear. Sexual relations should be avoided until treatment is complete. All sexual contacts should be notified and treated even if symptoms do not exist.

Prevention

Because chancroid is transmitted during sexual activity, the most reliable way to prevent infection is to abstain from oral, vaginal, and anal sex or to have a mutually monogamous relationship with an uninfected sex partner. Male and female condoms can reduce the risk of spreading the infection, but are not 100% reliable. Washing the genitals after sexual relations can also reduce the risk of infection.

If you think you are infected, avoid any sexual contact until you have been diagnosed and treated. Notify all sexual contacts so that they can be examined and treated. Avoid touching your open sores. If a sore is accidentally touched, wash your hands carefully to avoid spreading the infection to another part of the body.

Prognosis

Although chancroid is rare and does not cause any serious health problems, it is still important to consider prevention techniques such as mutual monogamy.

References:

1) Chancroid
Source: PubMed Health

2) Definition of Chancroid
Source: MedicineNet.com

3) Chancroid
Source: HealthCommunities.com

4) Chancroid
Source: Healthline.com

5) Chancroid
Source: PlannedParenthood.org

6) Genital Ulcers: Chancroid
Source: Physicians’ Desk Reference

7) Chancroid Treatment and Management
Source: Medscape.com

Posted in STI.