Chancroid

Chancroid is a sexually transmitted disease (STD) that is very contagious. It is caused by the bacteria Haemophilus Ducreyi and can be cured with antibiotics. Symptoms of chancroid include open sores on the genitals (or other areas of the body) and painful, swollen lymph nodes. In severe cases, the sores can cause scarring.

Chancroid is very common in parts of Asia and Africa, and is becoming more common in the United States.

Reporting

According to the Center for Disease and Control (CDC), in the United States there were 143 reported cases of chancroid in 1999 (source). However, it is believed to be grossly under reported and under diagnosed.
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Transmission

Chancroid is transmitted through physical skin to skin contact with an open sore. The contact can be sexual or nonsexual. Chancroid can also be spread to other areas of an infected person’s body when those areas come in contact with a sore.
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Symptoms

Symptoms of chancroid usually develop within ten days after being infected. Rarely do they develop in under three days or later than ten days.

Symptoms begin as a bump or bumps. A day or two after the bumps appear, they become open sores. The open sores can be up to 2 inches across, are filled with yellow or grey puss, are soft to the touch, bleed easily if scraped, can be painful, and may have well defined borders or ragged edges.

Women more commonly have multiple sores and can experience pain and bleeding during vaginal sex or pain when urinating. However, women are often unaware they have chancroid, because the sores are often not painful. For men, the sores are usually very painful.

Chancroid can also cause the lymph nodes in the groin to become swollen and painful. Usually this will occur only on one side of the body, but sometimes it can occur on both the right and left sides.
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Testing / Diagnosis

Most health care providers can diagnosis chancroid based on the characteristics of the open sores. If a health care provider may decide he or she needs further information to make a diagnosis, a sample can be taken from one of the sores and used to create a culture. If the bacterium Haemophilus Ducreyi is found, diagnosis of chancroid can be confirmed. The health provider could also use a gram stain to identify Haemophilus Ducreyi.
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Treatment

Chancroid can be cured with the antibiotics azithromycin, ciprofloxacin, or erythromycin. A health care provider can recommend which of these treatment options is best. Once treatment begins, symptoms should go away after three to seven days. Although larger sores can take up to two weeks to heal, and in severe cases, scarring may occur. A follow up examination is recommended after the three to seven days.

People with HIV or men who are not circumcised may not respond as well to treatment, and may need additional treatments.
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Complications

Chancroid can cause scarring of the foreskin in men who are not circumcised and may result in phimosis (tightness or constriction of the foreskin, making it unable to retract over the glans or head of the penis). This may require circumcision to be corrected.

In men and women, chancroid can infect the lymph nodes. The nodes can become a bubo, an enlargement and inflammation of one or more lymph nodes that have red skin over them. These buboes can be hard and painful and draining them surgically may be required to relieve the pain. If a bubo ruptures, it can be susceptible to a secondary infection.

The open sores from chancroid can increase the risk of being infected with HIV and can make it easier for people infected with HIV to spread it. People with HIV may also be slower to heal from chancroid, even with treatment.
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Prevention

To avoid the transmission of chancroid from sexual contact, abstaining from sexual contact is the surest way. A mutual monogamous relationship with a trusted partner known to be uninfected is another.

Using a latex condom during vaginal and anal sex can reduce the risk of transmission. Correctly using a condom can also reduce the risk of transmission during oral sex (mouth to penis). For other forms of oral sex (mouth to vulva, the outer female genital area, or oral to anal, also known as rimming) using a dental dam, plastic wrap, or a latex condom cut up and opened flat are risk reducers. However, chancroid can infect areas the condom or barrier method do not cover, so transmission is still possible during these types of sexual contact.

People who are infected should avoid touching the sores. Touching the sores can cause them to spread to other areas of the body.
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