15. Chancroid
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Chancroid is an acute sexually transmitted disease characterized by a painful genital ulcer and painful lymph node swelling. It is caused by the bacteria Haemophilus ducreyi. Incubation is typically 4 to 7 days. Symptoms include tender genital ulcers with well-defined borders and a gray or yellow discharge. Untreated, ulcers can enlarge and buboes may form abscesses. Diagnosis is by gram stain or culture of the ulcer. Treatment is with antibiotics like azithromycin or ceftriaxone. Left untreated, complications can include large draining ulcers or abscesses.
15. Chancroid
- 1. CHANCROID
- 2. Chancroid : яВЮ It is an acute STD characterized by a painful ulcer at the site of inoculation and development of suppurative regional lymphadenopathy. 2
- 3. Chancroid : яВЮ Etiology : Hemophilus ducreyi , a gram тАУve streptobacillus. яВЮ High incidence of HIV infection in patients with chancroid . Known to enhance infection rate. яВЮ Incubation period : 4 to 7 days. яВЮ Endemic in tropical 3rd world countries. 3
- 4. Skin lesion яВЮ Initially tender papule that evolves to pustule, erosion and ulcer. яВЮ Ulcer is quite tender and painful. яВЮ Borders are sharp undermined and not indurated. яВЮ Base of ulcer covered with gray to yellow exudate. 4
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- 7. Skin lesions : яВЮ Ulcers may be single or multiple or merge to form large ulcers. яВЮ Suppurative Lymphadenopathy ,painful, (usually unilateral) occur within 1 to 2 weeks of the lesion. яВЮ Buboes may drain spontaneously. 7
- 8. Investigations : яВЮ Gram stain: Scrapings from base of ulcer may show clusters of gram negative rods (SCHOOL OF FISH). яВЮ Culture : Difficult, special media, Sensitivity < 80%. яВЮ Serologic tests : None, Should be tested for syphilis and HIV. Repeat after 3 months if тАУ ve initially. 8
- 9. Management : яГШ Azithromycin : 1 gm Single dose. яГШ Inj. Ceftriaxone : 250 mg IM single dose. яГШ Ciprofloxacin : 500mg bid for 3 days. яГШ Reexamination after 3 to 7 days. яГШ Buboes may need to be aspirated. 9
- 10. Complications : яВЮ Large inguinal abscess may develop & rupture to form draining sinus or giant ulcer яВЮ Superinfection by Fusarium & Bacteroides яВЮ Phimosis- in long standing lesions
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