Chancroid
Disease Details
Family Health Simplified
- Description
- Chancroid is a bacterial sexually transmitted infection characterized by painful genital ulcers and swollen lymph nodes.
- Type
- Chancroid is a type of bacterial infection caused by the organism *Haemophilus ducreyi*. It is not transmitted genetically. Instead, it is a sexually transmitted infection (STI), primarily spread through sexual contact with an infected individual.
- Signs And Symptoms
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These are only local and no systemic manifestations are present.
The ulcer characteristically:
Ranges in size dramatically from 3 to 50 mm (1/8 inch to 2 inches) across
Is painful
Has sharply defined, undermined borders
Has irregular or ragged borders, described as saucer-shaped.
Has a base that is covered with a gray or yellowish-gray material
Has a base that bleeds easily if traumatized or scraped
Painful swollen lymph nodes occur in 30–60% of patients.
Dysuria (pain with urination) and dyspareunia (pain with intercourse) in femalesAbout half of infected men have only a single ulcer. Women frequently have four or more ulcers, with fewer symptoms. The ulcers are typically confined to the genital region most of the time.The initial ulcer may be mistaken as a "hard" chancre, the typical sore of primary syphilis, as opposed to the "soft chancre" of chancroid.Approximately one-third of the infected individuals will develop enlargements of the inguinal lymph nodes, the nodes located in the fold between the leg and the lower abdomen.Half of those who develop swelling of the inguinal lymph nodes will progress to a point where the nodes rupture through the skin, producing draining abscesses. The swollen lymph nodes and abscesses are often referred to as buboes. - Prognosis
- Prognosis is excellent with proper treatment. Treating sexual contacts of affected individual helps break cycle of infection.
- Onset
- The onset of chancroid is typically rapid. Symptoms often begin within 4 to 7 days after exposure, but can range from 1 to 14 days. Initial signs include the development of painful genital ulcers, usually accompanied by swelling and tenderness in the region.
- Prevalence
- Chancroid is a bacterial sexually transmitted infection caused by Haemophilus ducreyi. Its prevalence has decreased significantly in many parts of the world but remains endemic in certain regions, particularly in parts of Africa, Asia, and Latin America. It is relatively rare in developed countries, where it may occasionally be seen in travelers from endemic areas.
- Epidemiology
- Although the prevalence of chancroid has decreased in the United States and worldwide, sporadic outbreaks can still occur in regions of the Caribbean and Africa. Like other sexually transmitted infections, having chancroid increases the risk of transmitting and acquiring HIV.
- Intractability
- No, chancroid is not generally considered intractable. It is a bacterial infection caused by *Haemophilus ducreyi* and is treatable with appropriate antibiotics. Early diagnosis and treatment are crucial for effectively managing and curing the disease. If left untreated, however, it can lead to complications.
- Disease Severity
- Chancroid is generally considered a serious bacterial infection caused by Haemophilus ducreyi that leads to painful ulcers on the genitalia. It requires prompt medical attention for treatment and to prevent potential complications such as significant lymph node swelling and abscesses.
- Healthcare Professionals
- Disease Ontology ID - DOID:13778
- Pathophysiology
- Chancroid is a sexually transmitted infection caused by the bacterium *Haemophilus ducreyi*. In the pathophysiology of chancroid, the bacterium enters the skin or mucous membranes through microabrasions or microtrauma. Following infection, *H. ducreyi* releases virulence factors, such as cytolethal distending toxins and outer membrane proteins, which contribute to tissue destruction and ulcer formation. The primary clinical manifestation is the development of painful genital ulcers with ragged edges, often accompanied by inguinal lymphadenopathy. The body's immune response to the infection typically involves inflammation and infiltration by neutrophils, macrophages, and lymphocytes, but the bacteria's resistance to phagocytosis and evasion of the immune system can hinder clearance of the infection.
- Carrier Status
- Chancroid is not typically associated with a carrier status. It is an acute bacterial infection caused by Haemophilus ducreyi. Individuals who have the disease are symptomatic, usually presenting with painful ulcers on the genital area and swollen lymph nodes. There is no known asymptomatic carrier state for chancroid.
- Mechanism
-
Chancroid is a sexually transmitted infection caused by the bacterium *Haemophilus ducreyi*. The disease primarily affects the genital area, leading to painful ulcers. Here are the key points regarding its mechanisms and molecular mechanisms:
**Mechanism:**
1. **Infection and Colonization**: The bacterium *Haemophilus ducreyi* invades the epithelial tissue of the genital area through micro-abrasions or micro-tears in the skin.
2. **Ulcer Formation**: This invasion triggers an intense inflammatory response, leading to the formation of painful, soft ulcers (chancres). The ulcers are typically filled with a purulent exudate.
3. **Immune Evasion**: The bacterium can evade the host's immune system by several mechanisms, enhancing its persistence and pathogenicity.
**Molecular Mechanisms:**
1. **Adhesins**: *H. ducreyi* utilizes surface adhesins to attach to the host cells, which is the initial step in colonization.
2. **Cytotoxins**: The bacterium produces cytotoxins such as cytolethal distending toxin (CDT), which can damage host cells and contribute to ulcer formation.
3. **Outer Membrane Proteins (OMPs)**: These proteins play a role in immune evasion by resisting phagocytosis and killing by the host's immune cells.
4. **Lipoproteins and Lipooligosaccharides (LOS)**: These components of the bacterial cell envelope can trigger inflammatory responses and help the bacterium resist complement-mediated lysis.
5. **Iron Acquisition Systems**: *H. ducreyi* has specialized systems to acquire iron from the host, which is essential for its growth and survival in the host environment.
Together, these mechanisms allow *Haemophilus ducreyi* to establish infection, cause tissue damage, and avoid the host's immune defenses, resulting in the clinical manifestations of chancroid. - Treatment
- For the initial stages of the lesion, cleaning with soapy solution is recommended and Sitz bath may be beneficial. Fluctuant nodules may require aspiration. Treatment may include more than one prescribed medication.
- Compassionate Use Treatment
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Chancroid is a sexually transmitted infection caused by the bacterium Haemophilus ducreyi. When standard antibiotic treatments are ineffective or unavailable, compassionate use or off-label treatments may be considered.
Currently, the use of the following antibiotics is considered standard, but they also may be used in compassionate situations where standard options are not available:
- **Azithromycin:** A single oral dose of 1 gram.
- **Ceftriaxone:** A single intramuscular injection of 250 mg.
- **Erythromycin:** 500 mg orally, four times a day for 7 days.
- **Ciprofloxacin:** 500 mg orally, twice a day for 3 days.
Experimental treatments are currently not well-documented for chancroid. In some cases, alternative antibiotics may be considered off-label, but consultation with an infectious disease specialist is recommended to ensure proper treatment and management. - Lifestyle Recommendations
-
For chancroid, here are the lifestyle recommendations:
1. **Safe Sexual Practices**:
- Use condoms consistently and correctly to reduce the risk of transmission.
- Limit the number of sexual partners.
- Engage in regular sexual health check-ups, especially if you have multiple partners.
2. **Personal Hygiene**:
- Maintain good personal hygiene, especially in the genital area.
- Avoid sharing personal items that come into contact with the genitals.
3. **Prompt Medical Treatment**:
- Seek immediate medical attention if you notice symptoms like painful sores or ulcers on the genital area.
- Complete the full course of prescribed antibiotics if diagnosed with chancroid.
- Inform sexual partners if you are diagnosed, so they can also be tested and treated.
4. **Avoiding Alcohol and Substance Abuse**:
- Avoid behaviors that could compromise judgment and lead to risky sexual practices, such as excessive alcohol or drug use. - Medication
-
For treating chancroid, the following antibiotics are commonly recommended:
1. Azithromycin: A single oral dose of 1 gram.
2. Ceftriaxone: A single intramuscular dose of 250 milligrams.
3. Ciprofloxacin: 500 milligrams orally twice a day for 3 days.
4. Erythromycin: 500 milligrams orally three times a day for 7 days.
These medications help in resolving the infection caused by the bacterium *Haemophilus ducreyi*. - Repurposable Drugs
-
Chancroid, a bacterial sexually transmitted infection caused by Haemophilus ducreyi, has limited specific repurposable drug options. However, antibiotics effective against this bacterium are utilized, including:
1. **Azithromycin** - a macrolide antibiotic effective in single-dose therapy.
2. **Ceftriaxone** - a third-generation cephalosporin, also effective in a single dose.
3. **Ciprofloxacin** - a fluoroquinolone, taken orally over multiple days.
4. **Erythromycin** - a macrolide antibiotic, which requires multiple-day dosing.
Repurposing other antibiotics not traditionally associated with chancroid treatment is not widely documented, but these existing antibiotics are effective. - Metabolites
- Chancroid is a bacterial infection caused by Haemophilus ducreyi. There is limited specific information on unique metabolites associated with Haemophilus ducreyi or its pathogenesis. The primary focus of management involves identifying and treating the bacterial infection with antibiotics like azithromycin, ceftriaxone, ciprofloxacin, or erythromycin.
- Nutraceuticals
- There is limited evidence to support the use of nutraceuticals in the treatment or prevention of chancroid, a sexually transmitted infection caused by the bacterium Haemophilus ducreyi. The primary treatment involves antibiotics such as azithromycin, ceftriaxone, ciprofloxacin, or erythromycin. There is no established role for nanotechnology-based treatments (referred to as "nan.") in the current standard management of chancroid. It is essential to follow medical guidance for appropriate diagnosis and treatment.
- Peptides
- For chancroid, there is no widely recognized treatment involving peptides or nanoparticles (nanotech). Chancroid is a bacterial infection caused by *Haemophilus ducreyi*. The standard treatment includes antibiotics such as azithromycin, ceftriaxone, ciprofloxacin, or erythromycin. Research into novel treatments, including peptides or nanotechnology-based solutions, is ongoing but not currently a standard practice.