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Chancroid

Title               

Ñ    Chancroid

Definition

Ñ    Sexually transmitted disease

Caused by:

Ñ    Haemophilus ducreyi       

Pathogenesis

Organism

Ñ    Haemophilus ducreyi

Transmission

Ñ    Sexual contact

Pathological Process

Ñ    Organism enters skin through an epithelial break

Ñ    Secretes cyto lethal toxin

Ñ    Causes cell death

Ñ    Induces inflammation

Ñ    Results in an intradermal pustule

Ñ    Pustules break down to form ulcers

Clinical Features

History

Incubation period

Ñ    3-10 days

Examination

RAG

Ñ    Erythematous papule, which breaks down into an ulcer

Ñ    The ulcer has a necrotic base, ragged edge, bleeds easily and is painful

Ñ    Multiple ulcers occur and they may merge to form a serpiginous ulcer

Ñ    Inguinal lymphadenopathy develops and this is usually unilateral

Ñ    The lymphadenopathy may progress to form a large bubo

Males

Ñ    Prepuce and frenulum

Females

Ñ    Vaginal entrance and perineum

Investigations

Fluids

Swabs from ulcer, aspirate from lymph nodes

Ñ    Gram stain:

Coccobacilli

Ñ    PCR

Management

Cure

Drugs

Ñ    Azithromycin

Ñ    Ceftriaxone

Ñ    Ciprofloxacin

Ñ    Erythromycin

Prognosis

Ñ    Response in 3-7 days

Ñ    HIV infected patients may take longer to respond

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