chancroid (soft chancre)
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Introduction
Venereal disease due to Haemophilus ducreyi.
Etiology
Epidemiology
more common in tropical developing countries
Pathology
- deep necrotizing ulcers
Clinical manifestations
- constitutional symptoms
- lesions begin on genitalia or adjacent skin as small erythematous papules that suppurate, resulting in soft, painful ulcers with eroded or ragged edges
- may be single or multile lesions
- regional (inguinal) lymphadenitis (bubo) in 1/3 of patients
- dyspareunia (women)
- dysuria (women)
Laboratory
- smear of lesion
- culture of lesion
- test for coexistent sexually transmitted disease, including HIV
Differential diagnosis
Management
- pharmaceutical agents of choice
- azithromycin 1 g PO once
- ceftriaxone 250 mg IM once
- alternative agents
- ciprofloxacin 500 mg PO BID for 3 days
- erythromycin 500 mg PO QID for 7 days
- Augmentin 500 mg PO TID for 7 days
- aspiration of fluctuant nodes to prevent rupture
- avoid sexual activity for 1 week after treatment
- follow-up evaluation within 1 week
- treatment failure may indicate incorrect diagnosis[3]
More general terms
Additional terms
References
- ↑ DeGowin & DeGowin's Diagnostic Examination, 6th edition, RL DeGowin (ed), McGraw Hill, NY 1994, pg 873
- ↑ Harrison's Principles of Internal Medicine, 13th ed. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 541
- ↑ 3.0 3.1 Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 443-444
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 16, 17, 18. American College of Physicians, Philadelphia 2012, 2015, 2018.