Chancroid signs and symptoms

Chancroid signs and symptoms






Haemophilus ducreyi, a pleomorphic gram-negative facultative anaero­bic bacillus, is the causative agent.

The disease is common in tropical countries.

It is now common in the United States.

Disease is a cofactor for human immunodeficiency virus (HIV) trans­mission: 10% coinfection rate.

Approximately 10% of patients are coinfected with T. pallidum or herpes simplex virus (HSV).

Sexual contact is the only known method of transmission.





Incubation period is 2 to 10 days; with a median of 4 to 7 days.

“Soft chancre” is the primary clinical sign.

Shallow, tender, nonindurated ulcer with purulent base

Multiple ulcers in women: lesions on fourchette, labia, vestibule, and clitoris

Unilateral or bilateral inguinal adenopathy (bubo) present in 50% of cases.

Unilateral, 70%

Spontaneous rupture if untreated

In HIV patients ulcers are larger, persist longer, and have less extensive lymphadenopathy.




  1. ducreyi should be isolated from lesion or node aspirate.

Gram stain is insensitive and nonspecific, revealing a pleomorphic gram negative “school of fish” pattern.

Cultures require special media, are 60% to 80% sensitive, and difficult to grow

Rule out HSV, syphilis, and LGV.

Diagnostic criteria:

Isolation of H. ducreyi is definitive.

Otherwise, clinical diagnosis should include the following:

One or more painful genital ulcers

Negative darkfield examination, negative RPR

Negative HSV, negative LGV

Painful ulcer along with tender inguinal adenopathy is suggestive of chancroid.



Azithromycin, 1 g PO, single dose

Ceftriaxone, 250 mg IM, single dose

Erythromycin base, 500 mg, qid x 7 days

Ciprofloxacin, 500 mg PO, bid x 3 days

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