Chancroid

Definition

Chancroid is a disease known to be spread solely through sexual contact.

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.

Only a few hundred cases a year are diagnosed in the United States. The majority of individuals in the U.S. diagnosed with chancroid have traveled outside the country to areas where the disease is known to occur frequently.

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

Symptoms

After an incubation period of 1 day to 2 weeks, chancroid begins with a small bump 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
  
• Has irregular or ragged borders
  
• Has a base that is covered with a grey or yellowish-grey material
  
• 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 for ulcers 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 most common symptoms in women are pain with urination and pain with intercourse.

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

Approximately half of the infected individuals will develop enlargements 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 buboes.