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For further information, see CMDT Part 33-27: Chancroid

Key Features

  • A sexually transmitted disease caused by the gram-negative bacillus Haemophilus ducreyi

  • Incubation period is 3–5 days

Clinical Findings

  • Initial lesion at the site of inoculation is a vesicopustule that breaks down to form a painful, soft ulcer with a necrotic base, surrounding erythema, and undermined edges

  • Multiple lesions, started by autoinoculation, and inguinal lymphadenitis often develop

  • Lymphadenitis

    • Usually unilateral

    • Consists of tender, matted nodes of moderate size with overlying erythema

    • Nodes may become fluctuant and rupture spontaneously

  • With lymph node involvement, fever, chills, and malaise may develop

  • Balanitis and phimosis are frequent complications in men

  • Women may have no external signs of infection

Diagnosis

  • Culturing a swab of the lesion onto special medium

Treatment

  • A single dose of either azithromycin, 1 g orally, or ceftriaxone, 250 mg intramuscularly, is effective

  • Effective multiple-dose regimens

    • Erythromycin, 500 mg four times daily orally for 7 days

    • Ciprofloxacin, 500 mg twice daily orally for 3 days

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