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Chapter 187 Chancroid (Haemophilus ducreyi)
H. Dele Davies, Parvin H. Azimi
Chancroid is a sexually transmitted disease characterized by painful genital ulceration and inguinal lymphadenopathy.
Chancroid is caused by Haemophilus ducreyi, a fastidious gram-negative bacillus. It is prevalent in many developing countries but occurs sporadically in the developed world. Most Western cases occur in returning travelers (90% are male) from endemic areas, and some occur occasionally in localized urban outbreaks associated with commercial sex workers. This disease is a risk factor for transmission of HIV. Diagnosis of chancroid in infants and children is strong evidence of sexual abuse. Male circumcision lowers the risk for chancroid.
The incubation period is 4-7 days with a small inflammatory papule on the preputial orifice or frenulum in men and on the labia, fourchette, or perineal region in women. The lesion becomes pustular, eroded, and ulcerative within 2-3 days. The ulcer edge is classically ragged and undermined. Without treatment, the ulcers may persist for weeks to months. Painful, tender inguinal lymphadenitis occurs in > 50% of cases, more often among men. The lymphadenopathy can become fluctuant to form buboes, which can spontaneously rupture.
Diagnosis of chancroid is usually established by the clinical presentation and the exclusion of both syphilis (Treponema pallidum)
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