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Chancroid

Definition

Chancroid is a bacterial infection that is spread through sexual contact.

Alternative Names

Soft chancre; Ulcus molle; Sexually transmitted disease – chancroid; STD - chancroid; Sexually transmitted infection – chancroid; STI - chancroid

Causes

Chancroid is caused by a bacteria called Haemophilus ducreyi.

The infection is found in many parts of the world, such as Africa and southwest Asia. Very few people are diagnosed in the United States each year with this infection. Most people in the United States who are diagnosed with chancroid have traveled outside the country to areas where the infection is more common.

Symptoms

Within 1 day to 2 weeks after becoming infected, a person will get a small bump on the genitals. The bump becomes an ulcer within a day after it first appears. The ulcer:

  • Ranges in size from 1/8 inch to 2 inches in diameter
  • Is painful
  • Is soft
  • Has sharply defined borders
  • Has a base that is covered with a gray or yellowish-gray material
  • Has a base that bleeds easily if it is banged or scraped

About half of infected men have only a single ulcer. Women often have 4 or more ulcers. The ulcers appear in specific locations.

Common locations in men are:

  • Foreskin
  • Groove behind the head of the penis
  • Shaft of the penis
  • Head of the penis
  • Opening of the penis
  • Scrotum

In women, the most common location for ulcers is the outer lips of the vagina (labia majora). "Kissing ulcers" may develop. Kissing ulcers are those that occur on opposite surfaces of the labia.

Other areas, such as the inner vagina lips (labia minora), the area between the genitals and the anus (perineal area), and the inner thighs may also be involved. The most common symptoms in women are pain with urination and intercourse.

The ulcer may look like the sore of primary syphilis (chancre).

About half of the people who are infected with a chancroid develop enlarged lymph nodes in the groin.

In half of people who have swelling of the groin lymph nodes, the nodes break through the skin and cause draining abscesses. The swollen lymph nodes and abscesses are also called buboes.

Exams and Tests

The health care provider diagnoses chancroid by looking at the ulcer(s), checking for swollen lymph nodes and testing (ruling out) for other sexually-transmitted diseases. There is no blood test for chancroid.

Treatment

The infection is treated with antibiotics including ceftriaxone, and azithromycin. Large lymph node swellings need to be drained, either with a needle or local surgery.

Outlook (Prognosis)

Chancroid can get better on its own. Some people have months of painful ulcers and draining. Antibiotic treatment often clears up the lesions quickly with very little scarring.

Possible Complications

Complications include urethral fistulas and scars on the foreskin of the penis in uncircumcised males. People with chancroid should also be checked for other sexually transmitted infections, including syphilis, HIV, and genital herpes.

In people with HIV, chancroid may take much longer to heal.

When to Contact a Medical Professional

Call for an appointment with your provider if:

  • You have symptoms of chancroid
  • You have had sexual contact with a person who you know has a sexually transmitted infection (STI)
  • You have engaged in high-risk sexual practices

Prevention

Chancroid is spread by sexual contact with an infected person. Avoiding all forms of sexual activity is the only absolute way to prevent a sexually transmitted disease.

However, safer sex behaviors may reduce your risk. The proper use of condoms, either the male or female type, greatly decreases the risk of catching a sexually transmitted disease. You need to wear the condom from the beginning to the end of each sexual activity.

References

Mookerjee AL, Newell GC. Chancroid. In: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson I, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 40.

Murphy TF. Haemophilus species including H. influenzae and H. ducreyi (chancroid). In: Bennett JE, Dolin R, Mandell GL, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 227.

Review Date:9/10/2015
Reviewed By:Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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