Sexually Transmitted Diseases (STDs In Men) (cont.)
Diseases Associated With Genital Lesions
Chancroid
What is chancroid?
Chancroid is an infection that initially is seen in a
sexually exposed area of the skin. The infection typically appears on the penis
but also occasionally occurs in the anal or mouth area. Chancroid starts out as a tender bump that
emerges 3 to 10 days (the incubation period)
after the sexual exposure. The bump then erupts into an ulcer (an open sore),
which is usually painful. Often, there is an associated tenderness of the glands
(lymph nodes), for example, in the
groin of patients with penile bumps or ulcers. Chancroid is a relatively rare
cause of genital lesions in the U.S., but is much more common in many developing
countries.
How is chancroid diagnosed?
The diagnosis of chancroid is usually made by a culture
of the ulcer to identify the causative bacteria, Hemophilus ducreyi. A clinical
diagnosis (which
is made from the medical history and
physical examination) can be made if the patient has one or more painful ulcers
and there is no evidence for an alternative diagnosis such as syphilis or
herpes. The clinical diagnosis
justifies the treatment of chancroid even if cultures are not available.
Incidentally, the word chancroid means resembling a "chancre," which is the
medical term for the painless genital ulcer that is seen in syphilis. Chancroid
is also sometimes called "soft chancre" to distinguish it from the chancre of
syphilis, which feels hard to the touch.
How is chancroid treated?
Chancroid is almost always cured with a single oral dose
of 1 gram of azithromycin (Zithromax) or a single injection of ceftriaxone
(Rocephin). Alternative medications are ciprofloxacin (Cipro), 500 mg taken
twice per day by mouth for three days, or erythromycin, 500 mg taken four times
per day by mouth for 7 days. Whichever treatment is used, the ulcers should
improve within 7 days. If no improvement is seen after treatment, the patient
should be reevaluated for other causes of the ulcers. HIV-infected individuals
are at an increased risk of failing treatment for chancroid. They should
therefore be followed especially closely to assure that the treatment has
worked. In addition, someone diagnosed with chancroid should be tested for other
sexually transmitted diseases (such as chlamydia and gonorrhea), because more than one
infection can be present at the same time.
What should a person do if exposed to someone with chancroid?
A healthcare provider should evaluate anyone who has had
sexual contact with a person with chancroid. Whether or not the exposed
individual has an ulcer, they should be treated if they were exposed to their
partner's ulcer. Likewise, if they had contact within 10 days of the onset of their partner's ulcer, they
should be treated even if their partner's ulcer was not present at the time of
the exposure.
Next: Genital Herpes »
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