Chancroid

Definition:

A sexually-transmitted disease that is not known to be spread any other way.

Causes, incidence, and risk factors:

Chancroid is a bacterial infection caused by the organism Haemophilus ducreyi. It is a disease found primarily in developing and third world countries, but cases are continuously diagnosed in the United States. The majority of individuals in the U.S. diagnosed with chancroid have traveled in endemic areas outside the country (areas where the disease is known to occur frequently).

Chancroid begins with a small bump (papule) that becomes an ulcer within a day of its appearance. The ulcer characteristically:

• ranges in size dramatically (from 1/8 inch to 2 inches across)
• is painful
• has sharply defined borders (sharply demarcated)
• has irregular or ragged borders
• has a base that is covered with a grey or yellowish-grey material (exudate)
• has a base that bleeds easily if traumatized or scraped

About half of infected men have only a single ulcer. Women frequently have 4 or more ulcers. The ulcers appear in specific locations.

Common locations in men (most common to least common) are:

• foreskin (prepuce)
• groove behind the head of the penis (coronal sulcus)
• shaft of the penis
• head of the penis (glans)
• opening of the penis (urethral meatus)
• scrotum

In women the most common location is the labia majora. "Kissing ulcers" may develop. These are ulcers that occur on opposing surfaces of the labia. Other areas such as the labia minora, perianal area, and inner thighs may also be involved.

The initial ulcer may be mistaken as a chancre, the typical sore of primary syphilis.

Approximately half of the infected individuals will develop enlargement of the inguinal lymph nodes, the nodes located in the fold between the leg and the lower abdomen. Half of those who develop swelling of the inguinal lymph nodes will progress to a point where the nodes rupture through the skin producing draining abscesses. The swollen lymph nodes and abscesses are often referred to as bubos.

Uncircumcised men are at 3 times the risk of circumcised men for contracting chancroid from an infected partner. Chancroid may also be a risk factor for contracting the HIV virus.