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General Medicine

Chancroid

Jeffrey T. Kirchner, DO, FAAFP, AAHIVS Reviewed 06/2019
 


BASICS

DESCRIPTION

  • A sexually transmitted infection characterized by painful genital ulcerations and inguinal adenopathy

  • Uncommon in the United States, present worldwide

  • Chancroid is endemic in developin...

DIAGNOSIS

HISTORY

  • Exposure to an infected individual

  • Local symptoms: dysuria, chancre (painful); inguinal lymph node swelling

  • Women can be asymptomatic carriers.

  • Systemic symptoms often lacking

PHYSICAL EXAM

TREATMENT

GENERAL MEASURES

  • Outpatient treatment

  • Saline or Burow solution to soak ulcers

  • Aspiration of buboes if >5 cm; approach through adjacent skin. Consider incision and drainage for larger lesions...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Avoid sexual activity until ulcers are resolved.

  • Clinical improvement usually occurs within 48 hours.

  • Reexamine patients 3 to 7 days after initiat...

REFERENCES

1
Braxton J, Davis D, Flagg E, et al. 2016 Sexually Transmitted Disease Surveillance. Atlanta, GA: Division of STD Prevention, Centers for Disease Control and Prevention; 2017. http://www.cd...

ADDITIONAL READING

  • Janowicz DM, Li W, Bauer ME. Host-pathogen interplay of Haemophilus ducreyi. Curr Opin Infect Dis.  2010;23(1):64–69. [View Abstract on OvidMedline]

  • Janowicz DM, Ofner S, Katz B...

CODES

ICD10

A57 Chancroid 

ICD9

099.0 Chancroid 

SNOMED

  • 266143009 Chancroid (disorder)

  • 402954007 Penile chancroid (disorder)

  • 402955008 Vulval chancroid (disorder)

  • 240585002 chancroid - anogenital ulcer (disor...

CLINICAL PEARLS

  • Chancroid is characterized by genital papules that progress to pustules and then open painful ulcers. Chancroid is rare in the United States.

  • Azithromycin is the treatment of choice.

  • Tre...

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FIGURE 19.14 Chancroid. This patient has multiple painful ulcers on the glans penis.
FIGURE 19.14 Chancroid. This patient has multiple painful ulcers on the glans penis.
Figure 107.1. Characteristics of H. ducreyi. (A) The colonies are tan-gray and approximately 0.5 to 1 mm in diameter. The colonies can be nudged intact across the agar surface. (B) The intracellular adhesion shown may account for the tenacious characteristics of the colony.
Figure 107.1. Characteristics of H. ducreyi. (A) The colonies are tan-gray and approximately 0.5 to 1 mm in diameter. The colonies can be n...
Figure 107.4. Genital ulcers. (A) The eroded purulent ulcer of chancroid is painful and may be associated with painful inguinal adenitis. (B) Lymphogranuloma venereum has a small, transient genital ulcer with swollen, extremely painful inguinal lymph nodes. (C) The genital lesions of GI are painless, beefy red, raised lesions. (Part C from Al-Harmozi SA, el-Tonsy MH. Granulmoa inguinale. Report of the first case in Qatar. Sex Transm Dis1986;13:102, with permission.)
Figure 107.4. Genital ulcers. (A) The eroded purulent ulcer of chancroid is painful and may be associated with painful inguinal adenitis. (...
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