Chancroid / Ulkus Mole

Vitria Dwiayu

DEFINISI
Penyakit infeksi genitalia akut, setempat,
disebabkan oleh Haemophilus ducreyi, dengan
gejala klinis khas berupa ulkus sdan seringkali
desertai supurasi kelenjar getah bening regional

ETIOLOGI
Haemophilus ducreyi
Gram (-)
anaerob fakultatif
coccobacillus

EPIDEMIOLOGI
Penularan melalui hubungan seksual (kulit yg
terluka)
Daerah tropis dan subtropis
Secara kebetulan juga dapat mengenai jari
dokter atau perawat
Bersifat endemik dan tersebar di daerah tropik
dan subtropik, terutama di kota dan pelabuhan

GEJALA KLINIS

Nyeri pada genital

Papul pustul ulkus
Letak :

Pria = frenulum, glans, preputium, sul.coronarius

Wanita = labia minor, fourchette

DIAGNOSIS BANDING
1. Herpes simplex virus

caused by herpes simplex virus type 1 or type 2

lesions are typically painful, erythematous vesicles, ulcers, or pustules

2. Sifilis

Treponema pallidum
ulcers are typically painless

3. Granuloma Inguinal
disebabkan oleh Klebsiella granulomatis
dimulai pada daerah genitalia eksterna, paha, lipatan paha, atau perinuem

4. Lymphogranuloma venereum
mengenai sistem saluran pembuluh limfe dan kelenjar limfe, terutama
pada daerah genital, inguinal, anus dan rektum
Penyebabnya ialah Chlamydia trachomatis

DIAGNOSIS

Anamnesis
Px Fisik
Px Penunjang

Kultur
PCR
Screening HIV

PENATALAKSANAAN
Sirkumsisi
Dapat mengurangi faktor resiko terinfeksi

Antibiotik
Dapat mempercepat penyembuhan

 for confirmed cases treat with 1 of 4 regimens (preferred)

azithromycin 1 g orally in single dose
ceftriaxone 250 mg intramuscularly in single dose
ciprofloxacin 500 mg orally twice daily for 3 days (contraindicated during pregnancy and
lactation)
erythromycin base 500 mg orally 3 times daily for 7 days
alternatives (in regions where drugs are available) include
fleroxacin 400 mg or norfloxacin 800 mg in a single dose
spectinomycin 2 g intramuscularly in a single dose
for patients with HIV infection
ulcers may heal more slowly
treatment failure may be more likely with any regimen
longer courses or repeated courses of antibiotics may be needed
limited evidence for therapeutic efficacy of ceftriaxone and azithromycin regimens in
patients with HIV infection, ciprofloxacin or erythromycin may be preferred
additional considerations
note that isolates with intermediate resistance to either ciprofloxacin or erythromycin
have been reported
screen for other sexually transmitted infections, including HIV infection
examine and treat presumptively sexual contacts of patient (within 10 days prior to onset
of patients symptoms)
male patients who are uncircumcised may not respond as well to treatment
reexamine 3-7 days after start of therapy

KOMPLIKASI DAN PROGNOSIS

KOMPLIKASI
Fimosis
Infeksi sekunder

PROGNOSIS
Dapat sembuh tanpa komplikasi 3-7 hari
Dapat kambuh

REFERENSI
www.who.int
Ebscohost
repository.usu.ac.id