Chancroid
Chancroid – an acute sexually transmitted infection, also known as soft chancre, characterized by multiple ulcers of the genitals and also by inflammation of the lymph nodes.
Prevalence – the disease is endemic in the countries of Africa, Southeast Asia, South America. It is observed very rarely in Bulgaria. The predominant age is 16-40 years.
Etiology
The causative agent is the streptobacillus Haemophilus duceeyi – a gram-negative bacterium that is rod-shaped with rounded ends and a narrowing in the middle.
This streptobacillus at a temperature of 50 degrees Celsius dies in 5 minutes, and under the influence of a 5% solution of lysol and carbolic acid it dies in a few seconds.
Infection with this streptobacillus occurs only during intercourse, but exceptional cases of non-sexual infection of medical workers have also been described.
Risk factors
• Frequent change of sexual partners;
• Prostitution;
• Low socioeconomic status;
Clinical picture
• The incubation period in men – 2-10 days /usually 2-3 days/, in women – 2-8 weeks and persistent immunity is not built after recovery, that is, it is quite possible reinfection.
• At the point of penetration of the pathogen, a red spot is formed, on which a small nodule is formed, which can transform into a purulent pimple – a soft chancre. On the third to fourth day, the pustule opens and a small rapidly increasing ulceration is found. The ulcer has an irregular shape with a diameter of several centimeters to several millimeters. Small ulcers often form around large ulcerations. It is characteristic of them that they have a soft consistency, soreness, tendency to bleed.
• Varieties of soft chancre include diphtheria, follicular, gangrenous, etc.
• In men, ulcers are more often located on the foreskin, glans and body of the penis.
• In women, ulcerations most often appear on the labia majora and labia minora, but they can form in the groin, thighs and cervix.
• Typical signs of chancroid – regional lymphadenitis occurring 2-3 weeks after infection. Inguinal lymph nodes are most often affected – they are enlarged, and the skin above them acquires a bright red color. Gradually, the inflammatory processes subside and the regional lymphadenitis dissipates, but an ulcer appears in its center, from which a large amount of thick blood mixed with pus is released.
What are the complications?
• Phimosis;
• Paraphimosis;
• Gangrene of the penis
Prognosis is favorable with proper treatment complete clinical recovery is achieved.
Treatment of chancroid
Syphilis and HIV are first tested. Studies of sexual partners and the application of appropriate therapy to them are also necessary. After that, drug therapy is started.
The streptobacillus Haemophilus duceeyi, the causative agent of the disease, is sensitive to:
• azithromycin, which is administered once;
• Erythromycin – the course of treatment is usually about a week;
• Ceftriaxone – once;
• Ciprofloxacin – one-week therapy;
• Amoxicycline;
The patient is recommended to observe bed rest. For hygienic care, warm antibacterial baths with a manganese solution are prescribed. Ointments, creams and emulsions are applied.
Prevention
The prevention of chancroid is the exclusion of casual sexual contacts, reducing the number of intimate partners, it is mandatory to use protective equipment and observe all the rules of personal hygiene.
Furthermore, after stopping treatment for 1 year, it is recommended that the patient visit a specialist in venereal diseases and that a clinical-serological control be carried out monthly.
