Chancroid overview: Difference between revisions
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==Causes== | ==Causes== | ||
''Haemophilus ducreyi'' is a [[Growth medium|fastidious]] [[gram-negative]] coccobacillus causing [[chancroid]], a gential ulcer disease. Certain non-sexually transmitted strains may also cause cutaneous limb ulcers. | ''Haemophilus ducreyi'' is a [[Growth medium|fastidious]] [[gram-negative]] coccobacillus causing [[chancroid]], a gential ulcer disease. Certain non-sexually transmitted strains may also cause cutaneous limb ulcers. | ||
==Differential Diagnosis== | |||
Chancroid must be differentiated from other diseases that cause genital ulcers and lymphadenopathy including syphilis, herpes simplex, dermatologic aspects of Behçet's disease, dermatologic manifestations of Lymphogranuloma venereum, donovanosis, and fixed drug eruption. | |||
==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
Revision as of 21:19, 14 January 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Chancroid is a sexually transmitted infection characterized by painful sores on the genitalia. Chancroid is known to be spread from one to another individual through sexual contact.
Historical Perspective
Chancoid has been known to humans since the time of the ancient Greeks. Chancroid was first differentiated from syphilis by Leon Bassereau in 1852. Augusto Ducrey identified Haemophilus ducreyi as the causative organism for chancroid in the 1890s.
Pathophysiology
Chancroid may develop after transmission of Haemophilus ducreyi through breaks in human epithelium, most commonly through sexual contact. Fimbrialike proteins, Flp1, Flp2, Flp3, are suspected to form pili that assist in adhesion and microcolony formation. H. ducreyi induces secretion of interleukin-6 (IL-6) and interleukin-8 (IL-8), which causes inflammatory cells to form abscesses, leading to the formation of papules that may progress into pustules. H. ducreyi cytolethal distending toxin (HdCDT) is a major virulence factor that contributes to necrosis of myeloid and epithelial cells, causing ulceration. On gross examination, pastules, pustules, and ulcers and charactersitic features, depending on the stage of the disease. On microscopic examination, a three-zone structure is typical.
Causes
Haemophilus ducreyi is a fastidious gram-negative coccobacillus causing chancroid, a gential ulcer disease. Certain non-sexually transmitted strains may also cause cutaneous limb ulcers.
Differential Diagnosis
Chancroid must be differentiated from other diseases that cause genital ulcers and lymphadenopathy including syphilis, herpes simplex, dermatologic aspects of Behçet's disease, dermatologic manifestations of Lymphogranuloma venereum, donovanosis, and fixed drug eruption.
Epidemiology and Demographics
Infection levels are low in the western world, typically around one case per two million of the population (Canada, France, UK and USA). Most individuals diagnosed with chancroid have visited countries or areas where the disease is known to occur frequently, although outbreaks have been observed in association with crack cocaine use and prostitution.
Risk Factors
Uncircumcised men are at three times greater risk than circumcised men for contracting chancroid from an infected partner. Chancroid is a risk factor for contracting HIV, due to their ecological association or shared risk of exposure, and biologically facilitated transmission of one infection by the other.
Diagnosis
Symptoms
The characteristic lesion in chancroid is a painful ulcer. In men the most common site of this ulcer is the perpuce and in women the labia majora.
Treatment
Medical Therapy
The CDC recommendation for chancroid is a single oral dose of Azythromicin or a single IM dose of Ceftriaxone or oral Erythromycin for seven days.
References