Sexually Transmitted Diseases (STDs In Women) (cont.)
Chancroid
What is chancroid?
Chancroid is an infection caused by the bacterium Hemophilus ducreyi,
which is passed from one sexual partner to another. It begins in a sexually
exposed area of the genital skin, most commonly the
penis and vulva (the
female external genital organs including the
labia, clitoris, and entrance
to the vagina). Chancroid starts out as a tender bump that emerges 3 to10 days
(the incubation period) after the sexual exposure. The cells that
form the bump then begin to die, and the bump becomes an ulcer (an open sore) that is usually
painful. Often, there is an associated tenderness and swelling of the glands (lymph
nodes) in the groin that
normally drain lymph (tissue fluid) from the genital area; however, the painful
ulcer and tender lymph nodes occur together in only about one-third of
infections. Chancroid is common in developing countries but is a relatively rare
cause of genital ulcers in the U.S.
Diagnosis of chancroid
A clinical diagnosis of chancroid (which is made from the medical
history and physical examination) can be made if the patient has one or more
painful ulcers in the genital area and tests are negative for syphilis or
herpes. (The word chancroid means resembling a chancre, the genital ulcer
that is caused by syphilis. Chancroid sometimes is called
soft chancre to distinguish it from the chancre of syphilis that feels hard
to the touch. The ulcer of chancroid also is painful, unlike the ulcer of
syphilis that is painless.) The diagnosis of chancroid can be confirmed by a
culture of the material from within the ulcer for the bacterium Hemophilus
ducreyi. The clinical diagnosis justifies the treatment of chancroid even if
cultures are not available.
Treatment of chancroid
Chancroid is almost always cured
with a single oral dose of 1 gm of azithromycin (Zithromax) or a single
injection of ceftriaxone (Rocephin). Alternative medications are ciprofloxacin
(Cipro) or erythromycin, 500 mg taken three times per day by mouth for
seven days.
Whichever treatment is used, the ulcers should improve within seven days. If no
improvement is seen after treatment, the patient should be reevaluated for
causes of ulcers other than chancroid. HIV-infected individuals are at an
increased risk for failing treatment for chancroid and should be observed
closely to assure that the treatment has been effective.
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 exposed individuals have an ulcer,
they should be treated. Moreover, if the contact was 10 days or less before the
onset of their partner's ulcer, they should be treated.
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