Chancroid history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.; Nate Michalak, B.A.; Serge Korjian M.D.

Overview

The characteristic manifestation of chancroid is a painful, nonindurated ulcer. The ulcer may range from 1/8 to 2 inches in diameter and has irregular and sharp borders. Ulcers may discharge a grey/yellow exudate. Other symptoms include inguinal lymphadenitis (predominantly in males), known as buboes, and dysuria and dyspareunia in females. Probable cause of chancroid also includes negative tests for Treponema pallidum or syphilis and Herpes Simplex Virus (HSV).

Symptoms

Local Manifestations

The characteristic feature of chancroid is a genital lesion. Such lesions may also be found on limbs, in the case of cutaneous limb ulcers caused by chancroid. A patient may present with either of the following types of lesions, depending on the stage of infection:[1][2]

Ulcer characteristics:[3]

  • Ranges in size from 3 to 50 mm (1/8 to 2 inches) in diameter
  • Painful
  • Soft, nonindurated
  • Irregular border
  • Sharp margins
  • Grey/yellow exudate
  • May look like syphilitic chancre

Other Symptoms

  • Inguinal lymphadenitis in approximately 50% of patients, known as buboes (typically unilateral and predominantly in males)[4]
  • Dysuria in females[3]
  • Dyspareunia in females

CDC Standard Clinical Definition

The CDC's standard clinical definition for a probable case of chancroid includes all of the following:[5]

  • Patient has one or more painful genital ulcers. The combination of a painful ulcer with tender adenopathy is suggestive of chancroid; the presence of suppurative adenopathy is almost pathognomonic.
  • No evidence of Treponema pallidum is indicated by dark-field examination of ulcer or by a serologic test for syphilis performed at least 7 days after the onset of ulcer.
  • The clinical presentation is not typical of disease caused by Herpes Simplex Virus (HSV), or result of culture for HSV is negative.

References

  1. Chancroid. UpToDate (September 25, 2015). http://www.uptodate.com/contents/chancroid#H3 Accessed January 19, 2016.
  2. Spinola, S. M. (2002). "Immunopathogenesis of Haemophilus ducreyi Infection (Chancroid)". Infection and Immunity. 70 (4): 1667–1676. doi:10.1128/IAI.70.4.1667-1676.2002. ISSN 0019-9567.
  3. 3.0 3.1 Chancroid. Wikipedia (July 16, 2015). https://en.wikipedia.org/wiki/Chancroid Accessed January 15, 2016.
  4. Lewis, D A (2003). "Chancroid: clinical manifestations, diagnosis, and management". Sexually Transmitted Infections. 79 (1): 68–71. doi:10.1136/sti.79.1.68. ISSN 1368-4973.
  5. 2015 Sexually Transmitted Diseases Treatment Guidelines. Centers for Disease Control and Prevention (June 4, 2015). http://www.cdc.gov/std/tg2015/chancroid.htm Accessed January 21, 2016.


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