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Chancroid > Questions & Answers

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What is chancroid?
Chancroid is a highly contagious sexually transmitted disease (or STD), but it is curable. It is caused by a bacteria called Haemophilus Ducreyi (or H. Ducreyi). Chancroid causes ulcers or sores, usually of the genitals. Swollen, painful lymph glands in the groin area are often associated with chancroid. Left untreated, chancroid may make the transmission of HIV easier.




How common is it?
Chancroid is very common in Africa and parts of Asia, and it is becoming more common in the United States.




How is it transmitted?
Chancroid is transmitted in two ways:
  • Sexual transmission through skin-to-skin contact with an open sore
  • Non-sexual transmission by means of autoinoculation when contact is made with the pus-like fluid from the ulcer
A person is considered to be infectious (able to pass the bacteria to others) when ulcers or sores are present. This means what as long as there are chancroid sores on the body, the person can spread the infection. There has been no reported disease in infants born to women with active chancroid at time of delivery.



Symptoms
  • Symptoms usually occur within 10 days from exposure. They rarely develop earlier than three days or later than 10 days.
  • The ulcer or sore begins as a tender, elevated bump, or papule that becomes a pus-filled, open sore with eroded or ragged edges.
  • It is soft to the touch (unlike a syphilis chancre that is hard or rubbery). The term soft chancre is frequently used to describe the chancroid sore.
  • The ulcers can be very painful in men, but women are often unaware of them.
  • Because chancroid is often asymptomatic in women, they are often unaware that they are infected.
  • Painful lymph glands (or lymph nodes) may occur in the groin, usually only on one side of the body. However, they can sometimes occur on both the left and right sides.


Testing/Diagnosis
Diagnosis is made by isolating the bacteria Hemophilus Ducreyi in a culture from a genital ulcer or sore. The chancre is often confused with symptoms of other sexually transmitted diseases (STDs) like syphilis or herpes. Therefore, it is important that a healthcare provider rule these diseases out.

A gram stain to identify H. Ducreyi is possible but can be misleading because of other organisms found in most genital ulcers.




Treatment
Chancroid can be treated with antibiotics. Successful treatment does two things:
  • It resolves symptoms (or causes them to disappear).
  • It prevents transmission.
A follow-up examination should be conducted three to seven days after treatment begins. If treatment is successful, ulcers usually improve within three to seven days. The time required for complete healing is related to the size of the ulcer. Large ulcers may require two weeks or longer to heal. In severe cases, scarring may result.

Partners should be examined and treated regardless of whether symptoms are present.




What does it mean for my health?
Chancroid had been well established as a cofactor for HIV transmission. In other words, someone infected with chancroid may be more easily infected with HIV. Also, someone infected with both chancroid and HIV may transmit HIV more easily to a partner who is not infected. Moreover, persons with HIV may experience slower healing of chancroid, even with treatment, and may need to take medications for a longer period of time.

In addition there may be complications from chancroid. Complications include the following:
  • In 50% of cases, the lymph node glands in the groin become infected within five to eight days of appearance of initial sores.
  • Glands on one side become enlarged, hard, painful, and fuse together to form a bubo, an inflammation and swelling of one or more lymph nodes with overlying red skin. Surgical drainage of the bubo may be necessary to relieve pain.
  • Ruptured buboes are susceptible to secondary bacterial infections.
  • In uncircumcised males, new scar tissue may result in phimosis (constriction so the foreskin cannot be retracted over the glans or head of the penis). Circumcision may be required to correct this.


Reduce your risk
As with other sexually transmitted diseases (STDs) there are things people can do to reduce or eliminate the risk of infection with chancroid. These include the following:
  • Abstinence (not having sex) is a sure way to avoid infection.
  • Mutual monogamy (having sex with only one uninfected partner) is another way to avoid infection.
  • Latex condoms for vaginal, oral and anal sex reduce risk. Using latex condoms may protect the penis or vagina from infection but does not protect other areas such as the scrotum or anal area.
  • Water-based spermicides can be used along with latex condoms for additional protection during vaginal intercourse. Use of spermicide is not recommended nor found to be effective for oral or anal intercourse.
If a person does get chancroid, it is important for the infected person to avoid touching the infected area to prevent chance of autoinoculation.



Talk to your partner
You should talk to your partner as soon as you learn you have chancroid. Telling a partner can be hard, but it's important that you talk to your partner as soon as possible so she or he can get treatment.






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