Sexually Transmitted Disease





What Is Chancroid?
Who Gets Chancroid?
What Are The Symptoms?
How Is It Diagnosed?
How Is It Treated?
Can Chancroid Be Prevented?

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Sexually Transmitted Diseases
Terminology: Chancroid is also called soft chancre and ulcus molle.

What Is Chancroid?

Chancroid is a sexually transmitted disease (STD) caused by the bacteria Haemophilus ducreyi. It is most commonly found in the tropics. Only a small number of cases are diagnosed in the United States every year (less than 50) and those are mainly in the southern states. Most women with chancroid have no symptoms but they can carry and spread the disease without knowing it. Some scientists think people with active chancroid sores are more susceptible to catching the HIV virus if exposed.

Who Gets Chancroid?

It is most common in people who live in tropical climates and third world countries (and is closely associated with prostitution in those places). Historically in the States there have been outbreaks, usually via citizens who have traveled abroad or through infected people coming into the country. It can develop in anyone who has had vaginal, anal or oral intercourse with an infected person - even if that person has no symptoms. It is more likely to invade the genitals through existing sores, cuts or scratches.

What Are The Symptoms?

Most infected women will not develop noticeable symptoms. If they do, they are likely to occur 3 to 7 days after exposure and include a bump which:
• Is small, raised and surrounded by a red border.
• Takes on the appearance of a ulcer as it fills with pus after the first day.
• Bleeds easily if rubbed or scraped. The open running sore can easily be confused with genital herpes or primary syphilis.
• Appears alone or in groups. Most women have 4 or more sores which can run together to form one long narrow ulcer.
• Appear on the vulva, vagina, cervix, urethra or inner thigh.

Men are more likely to show symptoms, but tend to develop fewer sores than women (one on average). Sore(s) can appear on the penis, scrotum or urethra.

Within 5 to 8 days after the sore(s) appear, they either spontaneously disappear (50 percent of cases) or the bacteria invade nearby lymph glands in the groin (if untreated). The glands become hard and swollen and break through the skin and cause draining abscesses. These are called buboes (singular bubo). If untreated at this stage, buboes can become infected with other microorganisms.

How Is It Diagnosed?

Chancroid can easily be mistaken for primary syphilis, genital herpes and lymphogranuloma venereum (LGV - caused by the same bacteria that causes chlamydia). As there is no blood test for chancroid and the bacterium that causes it is difficult to culture, diagnosis has to be made by ruling out the other diseases first. All patients who present with ulcers on or around the genital area should be tested for syphilis, herpes and chlamydia. Once these are ruled out, a diagnosis is made by looking at the appearance of the ulcer and lymph nodes. You will need to undergo STD testing at your doctors or STD clinic to eliminate the other possibilities.

How Is It Treated?

It is usually cured with antibiotics:

• Azithromycin 1g orally in a single dose or
• Ceftriaxone 250mg injected in a single dose or
• Ciprofloxaci 500mg orally twice a day for 3 days* or
• Erythromycin base 500mg orally 3 times a day for 7 days.
* pregnant and breastfeeding women excluded.

If any buboes are present they will need to be drained with a needle or local surgery. Occasionally plastic surgery is necessary if the ulcers were particularly large and scar. You will need a follow-up exam every 3 months for a year to ensure the disease has been eradicated. Unfortunately the bacterium has developed a resistance to many of the common antibiotics used - what was once effective may not work as well anymore.

Can Chancroid Be Prevented?

The same STD prevention advice used for most STDs, also applies to chancroid. The proper use of condoms, including female condoms will dramatically decrease your exposure risk if used correctly (condoms need to be worn from start to end of sexual activity). As women can spread the disease unknowingly, it is important that they check for signs of the disease in their partner who is more likely to develop symptoms. All women should become aware of the most common symptoms of STDs and venereal diseases.

Other Information
Personal hygiene is also effective in reducing the transmission of chancroid. During World War I, simple washing with soap and water within a few hours of sexual exposure appeared to be effective in reducing risk of chancroid. Male circumcision can also help protect men from infection.

American Statistics

Cases of Chancroid in the U.S. (per thousand) between 1981-2009.

Since the 1950s the disease has been rapidly on the decline. There was an outbreak in the late 1980s which was linked to imported cases and spread through prostitution. It was rapidly treated and controlled before it could spread further.

  Related Articles on STDs

For more STI advice, see the following:

Genital warts, scabies and pubic lice: Signs, tests and therapies.
Reproductive system disorders: Gyno problems, signs.

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