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Chancroid

Chancroid

Because chancroid is a bacterial infection, antibiotics can cure it. Most commonly, erythromycin is prescribed for seven days or ciprofloxacin for three days.

What is chancroid?

Chancroid (pronounced shan-kroid) is a sexually transmitted disease caused by a bacterium called Hemophilus ducreyi. Though it’s most prevalent in developing and Third World countries, it’s found all over the globe. Doctors sometimes call it “soft chancre,” which refers to the characteristic sores or lesions that appear on the genitals. The infection is less common in circumcised men than in those who are not circumcised, but any sexually active person can get it. In the United States, only 28 cases of chancroid were reported in 2009, but since chancroid is hard to diagnose, experts think it’s underreported.

What are the symptoms?

Within three to seven days of exposure, one or more small bumps will form on or near the genitals. Within a day these bumps will become painful open sores, ranging in size from an eighth of an inch to 2 inches in diameter. Many people also experience achingly swollen lymph glands in the groin. Sometimes this swelling continues until the lymph nodes rupture through the skin and form abscesses called buboes. Some women don’t develop sores, but experience other symptoms such as soreness during urination or defecation, vaginal discharge, severely painful intercourse, or rectal bleeding.

How is chancroid diagnosed?

Because the lesions are similar to those caused by herpes and syphilis, the diagnostic procedure for chancroid isn’t straightforward. Culturing H. ducreyi in a lab is difficult, so doctors begin by ruling out herpes and syphilis. To test for herpes, your doctor will swab an open sore and send this sample to the lab to be cultured; a blood test can determine whether you have syphilis. If you’re diagnosed with chancroid, your doctor should test you for HIV — patients who have chancroid often have HIV as well. Even if your tests for HIV, herpes, and syphilis are negative, you should be retested in three months.

What are my treatment options?

Because chancroid is a bacterial infection, antibiotics can cure it. Most commonly, erythromycin is prescribed for seven days or ciprofloxacin for three days. (Ciprofloxacin isn’t recommended if you’re pregnant, lactating, or younger than 18.) Or you might take a single dose of azithromycin. Ceftriaxone is another single-dose option, given as a pill or an injection.(However, Ceftriaxone should not be taken with calcium containing products, because of the possibility of drug interactions.) The lesions and ulcers should heal within two weeks, although some slight scars may remain. Your doctor should reexamine you within three to seven days of your initial treatment, and your partner should be treated as well. You need to avoid sexual contact until the sores have completely healed, since the bacteria are present in any open sore and can be passed along.

Are there any complications associated with this condition?

If you seek treatment, you’ll be fine. If left untreated, the painful genital sores can last weeks or months. If you’re sexually active while you have open sores on your genitals, you’re likely to infect your partner(s). Chancroid and other diseases in which genital ulcers are present increase the risk of contracting HIV, the virus that causes AIDS, because the open sores are passages for the HIV virus to enter your body. Other complications include scarring and a slight narrowing of the urethral passage.

Am I immune to chancroid if I’ve already had it?

No, you can get it again if you have sex with an infected partner.

How can I avoid getting chancroid?

If you’re sexually active, use latex condoms unless both you and your partner are monogamous and have been tested for sexually transmitted diseases. If your partner has signs of a sore or rash, discharge, swelling, or pain in the genital area, urge him or her to visit the doctor and abstain from sex until your partner gets a clean bill of health. Using a latex condom can also greatly reduce your risk of contracting other STDs.

References

“STD Surveillance 2009, National Profile,” Centers for Disease Control and Prevention. Last updated Nov. 22, 2010.

Ceftriaxone,” Center for Drug Evaluation and Research, U.S. Food and Drug Administration, last update Sept. 11, 2007

“National Institute of Allergy and Infectious Diseases Fact Sheet. Other Important STDs.

Chancroid. Prim Care 1990 Mar, 17(1):145-52.

Bacterial STD Branch, Division of AIDS, STD, and TB Laboratory Research. National Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia.

Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines 2002.

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