DIAGNOSIS AND TREATMENT

OF
CHANCROID
Reski Harlianty Harli
Prajogo Kusuma
Advisor:
dr. Fauzan
Supervisor:
Dr. dr. Siswanto Wahab, Sp. KK

Definition
A sexually transmitted acute ulcerative disease usually
localized at the anogenital area and often associated
with inguinal adenitis or bubo.

Epidemiology
More recent reports from Southeast Asia and Africa
suggest that the incidence of chancroid may be
declining in the face of a rapidly rising incidence of
genital herpes. The prevalence of chancroid is higher in
lower socioeconomic groups. Recent epidemics in the
industrialized countries have usually been associated
with commercial sex work, the use of crack cocaine,
with syphilis and an increased risk of HIV infection. 23
cases of chancroid were reported to the Centers for
Disease Control and Prevention (CDC) in 2007.

Etiology
Haemophilus ducreyia Gram-negative, facultative
anaerobic coccobacillusis the causative agent.

Clinical Manifestation
Painful, soft ulcers with ragged undermined margins
develop 12 weeks after inoculation (usually prepuce
and frenulum in men and vulva, cervix, and perianal
area in women).

Chancroidal ulceration of the penis

with discharging inguinal bubo

Diagnosis
Gram Staining
Gram stain suggestive of Haemophilus ducreyi (gram
negative, slender rod or coccobacillus in a school of fish
pattern)

 Haemophillus ducreyi culture

Multiplex Polymerase Chain Reaction (M-PCR)

Differential Diagnosis
Herpes Genitalis

Sifilis

Treatment
Needle aspiration of fluctuant buboes
Azithromycin, 1 g orally in a single dose
Ceftriaxone 250 mg intramuscularly in a single dose
Ciprofloxacin500 mg orally twice daily for three days
Erythromycin, 500 mg orally four times daily for seven
days

Prognosis
The disease is self-limited and systemic spread does not
occur. Occasionally, without treatment, genital ulcer and
inguinal abscess have been reported to persist for years.
If no clinical improvement is evident 1 week after the
start of therapy, incorrect diagnosis, coinfection with
another STI, concomitant HIV infection, poor compliance,
or a resistant strain of H. ducreyi must be considered.
Infections do not confer immunity and reinfections are
possible. To avoid reinfections, patients must be
instructed to use condoms properly.

THANK
YOU