Chancroid

Last reviewed: 26 Apr 2022
Last updated: 24 Sep 2021

Summary

Definition

History and exam

Key diagnostic factors

  • genital papules
  • genital ulcers
  • lymphadenitis and buboes
More key diagnostic factors

Other diagnostic factors

  • urethritis and dysuria
  • vaginal discharge
  • dyspareunia
  • rectal pain or bleeding
  • rectovaginal fistula
  • extragenital ulcers
Other diagnostic factors

Risk factors

  • multiple sex partners
  • sexual contact with sex worker
  • unprotected intercourse
  • substance abuse
  • male sex
  • lack of circumcision (in men)
  • poor personal hygiene
  • asymptomatic carriage
More risk factors

Diagnostic investigations

1st investigations to order

  • Gram stain of ulcer swabs and bubo aspirates
  • culture of ulcer swabs or bubo aspirates
  • Haemophilus ducreyi PCR
  • syphilis serology (FTA-ABS test, Treponema pallidum particle agglutination [TPPA], treponemal enzyme immunoassay [EIA])
  • rapid plasma reagin (RPR) test
  • HSV PCR and viral cultures
  • HIV test
More 1st investigations to order

Investigations to consider

  • Haemophilus ducreyi serology
  • Haemophilus ducreyi antibiotic sensitivity
  • ulcer biopsy
  • darkfield microscopy for Treponema pallidum
More investigations to consider

Emerging tests

  • direct or indirect Haemophilus ducreyi antigen testing

Treatment algorithm

ACUTE

HIV-negative

HIV-positive

ONGOING

no response to initial treatment

Contributors

Authors

Tara Babu, MD, MSc

Adjunct Assistant Professor of Medicine

Division of Infectious Diseases

University of Rochester Medical Center

Rochester

NY

Disclosures

TB declares that she has no competing interests.

Acknowledgements

Dr Tara Babu would like to gratefully acknowledge Dr Marguerite A. Urban and Dr Christina Bailey, previous contributors to this topic. MAU and CB declare that they have no competing interests.

Peer reviewers

Eva Jungmann, FRCP, MSc

Consultant Physician

GUM/HIV Camden Primary Care Trust

Archway Sexual Health Clinic

London

UK

Disclosures

EJ declares that she has no competing interests.

Diane M. Janowicz, MD

Assistant Research Professor in Medicine

Indiana University Department of Medicine

School of Medicine

Indianapolis

IN

Disclosures

DMJ declares that she has no competing interests.

  • Chancroid images
  • Differentials

    • Syphilis infection
    • HSV infection
    • Lymphogranuloma venereum
    More Differentials
  • Guidelines

    • Sexually transmitted diseases treatment guidelines, 2021
    • 2017 European guideline for the management of chancroid
    More Guidelines
  • Patient leaflets

    Chlamydia

    Genital herpes

    More Patient leaflets
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