What is Chancroid?
Chancroid is a sexually transmitted disease which can be recognized by the extremely painful genital ulcers which are necrotizing in nature and are often associated with painful enlarged lymph nodes in the inguinal region. Although it is not as rampant in the world as it was before, it still remains a cause of concern because of its role as a cofactor in the transmission of human immunodeficiency virus (HIV).
Causative Factor of Chancroid
Chancroid is caused by a bacterium named as Haemophilus ducreyi. This is a gram negative, facultative, anaerobic bacterium which is highly infectious in nature. It gains entry into a person through disrupted skin and sets off an inflammatory reaction at the site of entry. This results in the production of a toxin which is the reason behind the necrotizing ulcers.
When a person comes in sexual contact of another person with purulent chancroid lesions, the disease gets transmitted. Non sexual sites like eyes and skin may also get infected through autoinoculation. The incubation period for the bacterium is 1 day to 2 weeks. It starts as a small inflammatory papule at the site of entry. The papule enlarges rapidly and within days, may develop into a painful deep ulcer. If the ulcer is not treated promptly, it may become suppurative, cause disfiguration and scarring and lead to painful inguinal lymphadenopathy.
Phagedenic chancroid is the term given to chancroid lesions which become superinfected. They often become necrosed and may have to be removed surgically.
Mortality and Morbidity Associated with Chancroid
Chancroid does not lead to death. But it may lead to painful, unilateral inguinal lymphadenopathy in 50% of cases. If the lymph nodes are left untreated, they may become suppurative in 25% cases. These nodes can rupture on their own and lead to formation of non-healing ulcers of the inguinal nodes.
Prevalence of Chancroid
Chancroid lesions are usually observed in uncircumcised men of South African origin, Women account for only 10% of all chancroid cases and are more likely to be asymptomatic carriers of the H. ducreyi bacteria.
Chancroid is commonly seen in young, sexually active population. In the United States, women in the age group of 15 to 19 years are most likely to suffer from this condition. Amongst males, the age group of 20 to 24 years is the most affected.
Symptoms of Chancroid
Symptoms of chancroid vary in men and women. Let us discuss the symptoms in them one by one.
The initial lesion in men is a small, red protuberance on the penis which opens in a day or two to form an ulcer. Apart from the penis, the ulcer may develop on the scrotum or any other part of the genitalia.
Symptoms in Women
Women usually remain asymptomatic. In those women who show symptoms, small red bumps develop on the labia, in between the labia and the anus or on the thighs. The bumps may be four or more in number. When these bumps ulcerate, they may cause severe pain during urination or bowel movement.
Diagnosis of Chancroid
Diagnosis is done after sample of fluid draining out from the open sores is sent for examination and the causative bacteria are identified.
Treatment of Chancroid
Antibiotics are the treatment of choice. However, if the ulcers do not respond to antibiotics, surgical excision is the treatment of choice. The excision helps in reducing the painful swelling but may lead to some scarring.