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Chancroid


Chancroid is a sexually transmitted bacterial infection. It is not widespread, though most sources say it is probably under reported. It is highly contagious, which results in periodic outbreaks. In the United States, these outbreaks have historically been among minority populations in urban areas. Outbreaks also occur when someone from the Unites States travels out of the country, contracts the infection, and returns to spread it in the US. In other countries, especially sub-Saharan Africa and tropical countries, chancroid occurs among men who regularly visit prostitutes. More men contract chancroid than women, and it is most common among those over the age of thirty-five. More heterosexual men contract it than homosexual men, perhaps because it can be asymptomatic in women. It is also called soft chancre, soft sore, or soft ulcer.

CHANCROID SYMPTOMS

The main symptom of chancroid is a small bump in the genitals that appears anywhere from one to fourteen days after a person contracts the infection, though the vast majority will occur within three to ten days. The bump is tender, and develops into an ulcer, a pus-filled open sore, within a day of when it appears. This painful ulcer can measure from 1/8 of an inch to two inches across. It can be recognized by its sharply defined, though sometimes irregular, borders. The base is covered with a gray or yellow-gray material and bleeds easily if it is banged or scraped. Some men only have one ulcer, while some have more, and women often have four or more ulcers. The ulcers are commonly found in men in the foreskin, in the groove behind the head of the penis, on the penis shaft, on the glans, or penis head, on the opening of the penis, and on the scrotum. In women, the most common location is on the labia majora, the outer lips of the vagina. These are sometimes called “kidding ulcers” because they develop facing each other on each of the vaginal lips. There can also be ulcers in the inner lips, the perineal area (the area between the vagina and anus), and the inner thighs. In women, the most common symptom besides the sore itself is pain during urination and intercourse, but other than that they are often not as aware of ulcers as men. This actually makes it possible for women to spread chancroid and not even know it.

CHANCROID CAUSES

In addition to the ulcers, about half the people who get a chancroid will also develop swelling of the lymph nodes in the fold between the leg and abdomen. Those swollen nodes will sometimes break through the skin and create draining abscesses. These are known as buboes. Chancroid is often diagnosed after tests for herpes and syphilis prove negative.

Chancroid is transmitted in one of two different ways. First, it is transmitted through sexual contact by rubbing against the open sores of another person. This happens most easily if you already have a cut or sore, however small. Chancre can be passed through oral, anal, or vaginal sex. Another way occurs when you make contact with the drainage from the ulcers of another person; if you touch their sores for any reason, sexual or not. A person is infectious when sores are present, so as long as there are any sores on the body at all, the person could transmit the disease to someone else. However, it does not seem to be transmitted to babies born to women with open chancroid sores.
chancroid
Image: Chancroid

CHANCROID DIAGNOSIS

Chancroid is diagnosed by looking at the ulcers; they are the most distinctive mark of this illness. These sores can be painful or painless, and appear on the penis, groin, vagina, or rectum. They can cause pain during sexual intercourse, urination, or bowel movements. A doctor will also check for swollen lymph nodes and get a culture from the base of the ulcer. If the illness actually is chancroid, it can be treated with common antibiotics, including azithromycin and erythromycin. If the lymph nodes have swollen to a large size, they will need to be drained, either by inserting a needle into the swollen node, or by local surgery. Chancroid can get better without treatment, but it is a slow process, and involves months of living with painful, open and draining sores, and significant scarring afterward. Antibiotic treatment, on the other hand, clears up the lesions and leaves very little scarring. Also, antibiotic treatment not only clears up the sores, it prevents them from transmitting the disease to others. If you have been diagnosed with chancroid, your partner should also be tested for the infection, even if they do not seem to have any symptoms.

CHANCROID TREATMENT

Left untreated, chancroid may result in urethral fistulas and scars on the foreskin. If you have chancroid, you should also be checked for syphilis, HIV, and genital herpes. Open chancroid sores can put you at high risk for HIV, so if you have a sore, do not engage in sexual activity until it is healed. If you already have HIV, you may find that chancroid sores take much longer to heal, even with antibiotic treatment. Other complications include more infections of the ruptured buboes, resulting in more complex illness to treat.

CHANCROID PREVENTION

The only way to prevent sexually transmitted diseases, including chancroid, is to avoid sexual activity altogether. Barring that, safe sex practices should be followed. Use condoms correctly, every time you have sex, especially if you or your partner has open sores. However, keep in mind that sores can appear on areas hat are not covered by condoms. Limit the number of sexual partners that you have relations with, and do not go back and forth between partners. Washing carefully before and after sex to clear away any bacteria on your body, and having sex only with one faithful partner can help prevent the spread of harmful bacteria, as well.

You should inform any sexual partners as soon as you are diagnosed with chancroid. They will need to see their own doctors and perhaps receive a course of antibiotics to ensure that chancroid does not spread.

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