15. Chancroid

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1. DR. BIJAY Kr. Yadav Holy Vision Technical Campus Shankhmul , Kathmandu Dermatology Department CHANCROID

2. Chancroid : It is an acute STD characterized by a painful ulcer at the site of inoculation and development of suppurative regional lymphadenopathy. 2

3. Chancroid : Etiology : Hemophilus ducreyi , a gram – ve streptobacillus . High incidence of HIV infection in patients with chancroid . Known to enhance infection rate. Incubation period : 4 to 7 days. Endemic in tropical 3 rd world countries. 3

4. Skin lesion Initially tender papule that evolves to pustule, erosion and ulcer. Ulcer is quite tender and painful. Borders are sharp undermined and not indurated. Base of ulcer covered with gray to yellow exudate. 4

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7. Skin lesions : Ulcers may be single or multiple or merge to form large ulcers. Suppurative Lymphadenopathy ,painful, (usually unilateral) occur within 1 to 2 weeks of the lesion. Buboes may drain spontaneously. 7

8. Investigations : Gram stain: Scrapings from base of ulcer may show clusters of gram negative rods (SCHOOL OF FISH). Culture : Difficult, special media, Sensitivity < 80%. Serologic tests : N one, Should be tested for syphilis and HIV. Repeat after 3 months if – ve initially. 8

9. Management : Azithromycin : 1 gm Single dose. Inj. Ceftriaxone : 250 mg IM single dose. Ciprofloxacin : 500mg bid for 3 days. Reexamination after 3 to 7 days. Buboes may need to be aspirated. 9

10. Complications : Large inguinal abscess may develop & rupture to form draining sinus or giant ulcer Superinfection by Fusarium & Bacteroides Phimosis - in long standing lesions

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