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Chancroid (soft chancer)Penile ulcer

 Chancroid (Soft Chancre)

Chancroid, sometimes called the "third" venereal disease (after syphilis and gonorrhea), is an acute, ulcerative infec- tion caused by Haemophilus ducreyi, a small, gram-negative coccobacillus. The disease is most common in tropical and subtropical areas and is more prevalent in lower socioeco- nomic groups, particularly among men who have regular contact with prostitutes. Chancroid is one of the most common causes of genital ulcers in Africa and Southeast Asia, where it serves as an important cofactor in the trans- mission of HIV infection. Chancroid probably is underdi- agnosed in the United States because most STD clinics do not have facilities for isolating H. ducreyi, and PCR-based tests are not widely available.

=>MORPHOLOGY

The primary lesion of chanchroid appears first as a papule that rapidly breaks down to produce a ulcer. 

 

=>Clinical features

The primary lesion of chanchroid appears within 4 to 7 days of inoculation. In male patients, the primary lesion is usually on the penis; in female patients, most lesions occur in the vagina or periurethral area. Over the course of several days, the surface of the primary lesion erodes to produce an irregular ulcer, which is more likely to be painful in males than in females. The regional lymph nodes, particu- larly in the inguinal region, become enlarged and tender in about 50% of cases within 1 to 2 weeks of the primary inoculation. In untreated cases, the inflamed and enlarged nodes (buboes) may erode the overlying skin to produce chronic, draining ulcers. A definitive diagnosis requires the identification of H. ducreyi using special culture media  sensitivity is <80%. Therefore, the diagnosis often is based on clinical grounds alone.


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