chancroid

chancroid

Chancroid is an acute sexually transmitted infection characterized by painful multiple ulcers of the genital organs, as well as inflammation of the lymph nodes. Frequency. Endemic disease in Africa, Southeast Asia, South America. In Russia, they are not often observed. The predominant age is 16-40 years. Etiology. The causative agent is streptobacillus Haemophilus duceeyi (gram-negative bacillus). Risk factors

• • Frequent change of sexual partners
  • Prostitution
  • Low socioeconomic status.

Clinical picture

• • The incubation period for men is 2-10 days (traditionally 2-3 days), for women it is 2-8 weeks.
  • At the site of the introduction of the pathogen, an edematous spot appears, on which a small nodule appears, transforming into a pustule. On the 3-4th day, the pustule opens, and a small, rapidly increasing ulceration is found. The ulcer has an irregular shape, a diameter of several millimeters to several centimeters, undermined serrated soft somewhat overhanging edges, an uneven bottom covered with purulent plaque. Around a large ulcer, small sores are not often located. The characteristic features of ulcers are soft texture, soreness, a tendency to bleeding, an acute inflammatory corolla within the ulcer.
  • Varieties of soft chancre include elevated, serpiginous, diphtheritic, follicular, gangrenous, phagedenic, etc.
  • In men, ulcers are more often localized on the foreskin, head and body of the penis.
  • In women, ulcers are most often found on the labia majora and labia minora, but may occur in the perineum, thighs, and cervix.
  • Typical signs of chancroid are regional lymphadenitis (bubo), which occurs 2-3 weeks after infection. The inguinal lymph nodes are more often affected: they are enlarged, soldered to each other and the skin, which acquires a bright red color. Gradually, the inflammatory phenomena subside, and the bubo resolves, or a fluctuation appears in its center and it opens with the release of a large amount of thick, blood-tinged pus.

Laboratory research

• • Microscopy of discharged ulcer with Grom or Romanovsky-Giemsa stain
  • Isolation of pathogen culture on nutrient media. Special Studies
  • ELISA
  • PCR. Differential Diagnosis
  • Syphilis
  • Herpes simplex
  • Lymphogranuloma venereal
  • Granuloma inguinal
  • Acute ulcer of the vulva of Lirschutz-Chapin.

Treatment

• • Tactics of conducting
  • Examination for syphilis
  • HIV testing
  • Examination and treatment of sexual partners.
  • Drug therapy
  • Azithromycin 1 g orally as a single dose
  • Ceftriaxone 250 mg IV as a single dose
  • Erythromycin 500 mg 4 times a day for 7 days
  • Ciprofloxacin 500 mg orally twice a day for 7 days
  • Amoxycycline-clavulanate (Augmentin) 500 mg/125 mg orally 3 times a day for 7 days.

Complications

• • phimosis
  • paraphimosis
  • Gangrene of the penis. The prognosis is complete clinical recovery with appropriate treatment.

Synonyms

• Chancroid
• Chancroid
• The third venereal disease See also fig. 2-18 ICD. A57 Shankroid