Chancroid | Symptoms | Causes | Treatment

What is Chancroid? Chancroid | Symptoms | Causes | Treatment

Chancroid is a contagious STI, that has declined globally (in developed and underdeveloped countries), but still in some areas of Caribbean States, and Africa you can see chancroid patients. It is a bacterial infection caused by the bacterium Haemophilus ducreyi, which causes open sores on and around the genitalia. Chancroid is characterized by painful genital ulcers and can cause severe genital discomfort. Other symptoms can include inguinal lymphadenopathy, discharge, and fever. The ulcer may bleed or produce a contagious fluid that can spread bacteria during oral, anal, or vaginal intercourse. Chancroid may also spread from skin-to-skin contact with a contagious person. It is a sexually transmitted infection, meaning that it can travel from one person to another through sexual contact. An unsafe sexual intimacy is the main medium for its transmission. It is treatable with antibiotics, but if left untreated it can lead to serious complications.

Symptoms of Chancroid

Chancroid is a sexually transmitted disease that affects the genital area. The most common symptoms are as under;

1. Painful ulcers: The first symptom of chancroid is usually the appearance of one or more painful ulcers on the genital area, which can be red and swollen.
2. Swollen lymph nodes: The lymph nodes in the groin area may become swollen and tender, which is known as bubo.
3. Discharge: A person with chancroid may experience a yellowish or greenish discharge from the genital area.
4. Burning sensation: People with chancroid may experience a burning sensation during urination or sexual activity.
5. Pain: Pain in the genital area may be severe, especially when urinating.

It is important to see a doctor if you have any of these symptoms or suspect that you may have chancroid. Early diagnosis and treatment can prevent further complications and the spread of the disease to others.

Complications of Chancroid

Chancroid, if not treated timely, may result in several medical conditions, such as;

1. Lymph node enlargement: Chancroid can cause swelling of the lymph nodes in the groin, which can lead to abscess formation and subsequent pain and discomfort.
2. Genital ulceration: Chancroid causes painful genital ulcers, which can lead to secondary infections, scarring and genital deformities.
3. Spread of infection: Chancroid can spread to other parts of the body, including the rectum, anus and urethra, leading to more painful ulcers and increased risk of HIV transmission.
4. Fistula Formation: Chancroid can cause the formation of a fistula (an abnormal connection) between the skin and the rectum or vagina.
5. Pelvic inflammatory disease: In women, chancroid can spread to the cervix, uterus and fallopian tubes, causing pelvic inflammatory disease.
6. Disseminated chancroid: In rare cases, chancroid can spread throughout the body, leading to skin lesions, joint pain, fever and general malaise.
7. HIV transmission: People with chancroid are at a higher risk of acquiring and transmitting HIV due to the presence of open sores in the genital area.
8. Long-term scarring: Chronic chancroid infections can lead to scarring, which can cause pain, deformity and reduced sexual function.

Causes of Chancroid

The main cause of Chancroid is a bacterium called Haemophilus ducreyi. This bacterium is transmitted through sexual contact and causes open sores or ulcers in the genital area. It can also spread through close skin-to-skin contact, such as when the ulcers come into contact with the skin of a partner during sexual activity. Chancroid is more common in developing countries but can occur anywhere.

Risk Factors of Chancroid

You are at high risk in the following situations. The risk of infection is greater if there is;

1. Poor hygiene: People who practice poor hygiene habits, such as not washing their hands or genitals, are at an increased risk of contracting chancroid.
2. Crowded living conditions: People who live in overcrowded areas, such as slums or refugee camps, are more likely to get chancroid due to increased contact with infected individuals.
3. Lack of access to medical care: People in areas with limited access to medical care may be more likely to get chancroid because they are unable to get proper treatment for the infection.
4. Drug use: People who use intravenous drugs are at a higher risk of developing chancroid due to shared needles.
5. Multiple sexual partners: People who have multiple sexual partners are at an increased risk of contracting chancroid because they are exposed to more people who may be carrying the bacterium.
6. Unprotected sex: People who have unprotected sex, such as without using a condom, are more likely to get chancroid because the skin-to-skin contact makes it easier for the bacterium to spread.
7. HIV/AIDS: People with HIV or AIDS are at a higher risk of developing chancroid, as their weakened immune systems make it easier for the bacteria to infect them.

Prevention of Chancroid

As the infection is caused by the transmission of the bacteria through sexual activity with an infected person, therefore, having a safe sexual activity can prevent the infection. Following precautionary measures can reduce the cause and risk of spread of the infection.

1. Practice Safe Sex: Using a latex condom during sexual activity reduces the risk of chancroid transmission.
2. Avoid Multiple Partners: Limiting the number of sexual partners helps reduce the risk of exposure to the bacteria that causes chancroid.
3. Get Tested Regularly: Regular testing for STDs is important in detecting and treating chancroid and other sexually transmitted infections.
4. Treat Symptoms Promptly: If you experience symptoms of chancroid, seek medical treatment as soon as possible to prevent the spread of the infection to others.
5. Practice Good Hygiene: Keeping the genital area clean and dry helps reduce the risk of chancroid and other STDs.
6. Get Vaccinated: The HPV vaccine helps protect against certain strains of the human papillomavirus, which can increase the risk of chancroid and other STDs.
7. Avoid Substance Abuse: Substance abuse, particularly drug use and excessive alcohol consumption, can increase the risk of engaging in risky sexual behavior that leads to chancroid and other STDs.

Diagnosis of Chancroid

The above-mentioned signs and symptoms can help diagnose the infection. Your healthcare provider will detect the infection by physical examination of the pelvic region. Apart from the physical examination, there are some diagnostic tests used to identify the Chancroid infection;

1. Microscopic examination: A sample of fluid from the sores will be taken and examined under a microscope to look for the bacteria that causes chancroid, Haemophilus ducreyi.
2. Culture test: A sample of the fluid from the sores will be taken and cultured in a laboratory to confirm the presence of the bacteria.
3. Nucleic Acid test: A definitive diagnosis of chancroid requires the identification of H. ducreyi on special culture media. However, culture media for chancroid are not widely available. Nucleic acid amplification tests can be performed in clinical laboratories that have developed their own tests.
4. Polymerase chain reaction (PCR) test: This test uses a sample of fluid from the sores to identify the DNA of the bacteria that causes chancroid.
5. Blood test: A blood test can be done to look for antibodies against the bacteria that causes chancroid, which can indicate if the person has been exposed to the bacteria in the past.
6. Test of herpes simplex virus: A probable diagnosis of chancroid can be made if test for herpes simplex virus performed on the ulcer exudate is negative

It is important to note that chancroid can be mistaken for other sexually transmitted infections such as syphilis or herpes, so a thorough medical evaluation and laboratory testing are crucial for accurate diagnosis.

Treatment of Chancroid

Successful antimicrobial treatment for chancroid cures the infection, resolves the clinical symptoms, and prevents transmission to others. In advanced cases, genital scarring and rectal or urogenital fistulas from suppurative buboes can result despite successful therapy.

1. Azithromycin 1 gm orally in a single dose
2. Ceftriaxone 250 mg IM in a single dose
3. Ciprofloxacin 500 mg orally 2 times/day for 3 days
4. Erythromycin base 500 mg orally 3 times/day for 7 days

• Zenker’s Diverticulum
• Pelvic Inflammatory Disease
• Mycoplasma Genitalium (MGen)
• Human Papillomavirus Infection
• Genital Herpes

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