Chancroid history and symptoms: Difference between revisions

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Latest revision as of 17:21, 18 September 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.; Nate Michalak, B.A.; Serge Korjian M.D.

Overview

The characteristic manifestation of chancroid is a painful, nonindurated ulcer. The ulcer may range from 1/8 to 2 inches in diameter and has irregular and sharp borders. Ulcers may discharge a grey/yellow exudate. Other symptoms include painful inguinal lymphadenitis (predominantly in males), known as buboes, and dysuria and dyspareunia in females. Probable cause of chancroid also includes negative tests for Treponema pallidum or syphilis and Herpes Simplex Virus (HSV).

Symptoms

Local Manifestations

The characteristic feature of chancroid is a genital lesion. Such lesions may also be found on limbs, in the case of cutaneous limb ulcers caused by chancroid. A patient may present with either of the following types of lesions, depending on the stage of infection:^[1]

Erythematous papules
Pustules
Ulcers

Ulcer characteristics:^[2]

Ranges in size from 3 to 50 mm (1/8 to 2 inches) in diameter
Painful
Soft, nonindurated
Irregular border
Sharp margins
Grey/yellow exudate
May look like syphilitic chancre

Other Symptoms

Painful inguinal lymphadenitis in approximately 50% of patients, known as buboes (typically unilateral and predominantly in males)^[3]
Dysuria in females^[2]
Dyspareunia in females

CDC Standard Clinical Definition

The CDC's standard clinical definition for a probable case of chancroid includes all of the following:^[4]

Patient has one or more painful genital ulcers. The combination of a painful ulcer with tender adenopathy is suggestive of chancroid; the presence of suppurative adenopathy is almost pathognomonic.
No evidence of Treponema pallidum is indicated by dark-field examination of ulcer or by a serologic test for syphilis performed at least 7 days after the onset of ulcer.
The clinical presentation is not typical of disease caused by Herpes Simplex Virus (HSV), or result of culture for HSV is negative.

References

↑ Spinola, S. M. (2002). "Immunopathogenesis of Haemophilus ducreyi Infection (Chancroid)". Infection and Immunity. 70 (4): 1667–1676. doi:10.1128/IAI.70.4.1667-1676.2002. ISSN 0019-9567.
↑ ^2.0 ^2.1 Chancroid. Wikipedia (July 16, 2015). https://en.wikipedia.org/wiki/Chancroid Accessed January 15, 2016.
↑ Lewis, D A (2003). "Chancroid: clinical manifestations, diagnosis, and management". Sexually Transmitted Infections. 79 (1): 68–71. doi:10.1136/sti.79.1.68. ISSN 1368-4973.
↑ 2015 Sexually Transmitted Diseases Treatment Guidelines. Centers for Disease Control and Prevention (June 4, 2015). http://www.cdc.gov/std/tg2015/chancroid.htm Accessed January 21, 2016.

Template:WikiDoc Sources

[Spinola2002-1] Spinola, S. M. (2002). "Immunopathogenesis of Haemophilus ducreyi Infection (Chancroid)". Infection and Immunity. 70 (4): 1667–1676. doi:10.1128/IAI.70.4.1667-1676.2002. ISSN 0019-9567.

[ChancroidWikipedia-2] 2.0 ^2.1 Chancroid. Wikipedia (July 16, 2015). https://en.wikipedia.org/wiki/Chancroid Accessed January 15, 2016.

[Lewis2003-3] Lewis, D A (2003). "Chancroid: clinical manifestations, diagnosis, and management". Sexually Transmitted Infections. 79 (1): 68–71. doi:10.1136/sti.79.1.68. ISSN 1368-4973.

[Chancroid_CDC-4] 2015 Sexually Transmitted Diseases Treatment Guidelines. Centers for Disease Control and Prevention (June 4, 2015). http://www.cdc.gov/std/tg2015/chancroid.htm Accessed January 21, 2016.

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[2]

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[4]

@@ Line 1: / Line 1: @@
 __NOTOC__
 {{Chancroid}}
-{{CMG}}
+{{CMG}}; {{AE}} {{YD}}; {{NRM}}; {{SSK}}
-Please help WikiDoc by adding more content here.  It's easy!  Click  [[Help:How_to_Edit_a_Page|here]]  to learn about editing.
 ==Overview==
-The characteristic lesion in  chancroid is a painful [[ulcer]]. In men the most common site of this ulcer is the [[perpuce]] and in women the [[labia majora]].
+The characteristic manifestation of chancroid is a painful, nonindurated [[ulcer]]. The ulcer may range from 1/8 to 2 inches in diameter and has irregular and sharp borders. Ulcers may discharge a grey/yellow exudate. Other symptoms include painful [[inguinal]] [[lymphadenitis]] (predominantly in males), known as [[Bubo|buboes]], and [[dysuria]] and [[dyspareunia]] in females. Probable cause of chancroid also includes negative tests for ''[[Treponema pallidum]]'' or [[syphilis]] and [[Herpes Simplex Virus|Herpes Simplex Virus (HSV)]].
-==Symptoms==
-After an incubation period of one day to two weeks, chancroid begins with a small bump that becomes an ulcer within a day of its appearance. The ulcer characteristically:
-*Ranges in size dramatically from 3 to 50 mm (1/8 inch to two inches) across
-*Is painful
-*Has sharply defined, undermined borders
-*Has irregular or ragged borders
-*Has a base that is covered with a gray or yellowish-gray material
-*Has a base that bleeds easily if traumatized or scraped
-More specifically, the CDC's standard clinical definition for a probable case of chancroid includes all of the following:
-*Patient has one or more painful genital ulcers. The combination of a painful ulcer with tender adenopathy is suggestive of chancroid; the presence of suppurative adenopathy is almost pathognomonic.
-*No evidence of ''[[Treponema pallidum]]'' is indicated by dark-field examination of ulcer or by a serologic test for [[Syphilis]] performed at least 7 days after the onset of ulcer.
-*The clinical presentation is not typical of disease caused by [[human herpesvirus 2]] ([[Herpes Simplex Virus]]), or result of culture for HSV is negative.
+==Symptoms==
+===Local Manifestations===
+The characteristic feature of chancroid is a genital lesion. Such lesions may also be found on limbs, in the case of cutaneous limb ulcers caused by chancroid. A patient may present with either of the following types of lesions, depending on the stage of infection:<ref name="Spinola2002">{{cite journal|last1=Spinola|first1=S. M.|title=Immunopathogenesis of Haemophilus ducreyi Infection (Chancroid)|journal=Infection and Immunity|volume=70|issue=4|year=2002|pages=1667–1676|issn=00199567|doi=10.1128/IAI.70.4.1667-1676.2002}}</ref>
+*Erythematous [[papules]]
+*[[Boil|Pustules]]
+*[[Ulcers]]
-About half of infected men have only a single ulcer. Women frequently have four or more ulcers, with fewer symptoms. The ulcers appear in specific locations, such as the coronal sulcus of the uncircumcised glans penis in men, or the fourchette and labia minora in women.
+Ulcer characteristics:<ref name="ChancroidWikipedia">Chancroid. Wikipedia (July 16, 2015). https://en.wikipedia.org/wiki/Chancroid Accessed January 15, 2016.</ref>
+*Ranges in size from 3 to 50 mm (1/8 to 2 inches) in diameter
+*Painful
+*Soft, nonindurated
+*Irregular border
+*Sharp margins
+*Grey/yellow exudate
+*May look like syphilitic chancre
-===Common locations in men (from most common to least common)===
+===Other Symptoms===
-*[[Foreskin]] (prepuce) (most common)
+*Painful [[inguinal]] [[lymphadenitis]] in approximately 50% of patients, known as [[Bubo|buboes]] (typically unilateral and predominantly in males)<ref name="Lewis2003">{{cite journal|last1=Lewis|first1=D A|title=Chancroid: clinical manifestations, diagnosis, and management|journal=Sexually Transmitted Infections|volume=79|issue=1|year=2003|pages=68–71|issn=13684973|doi=10.1136/sti.79.1.68}}</ref>
-*Groove behind the head of the penis ([[coronal sulcus]])
+*[[Dysuria]] in females<ref name="ChancroidWikipedia" />
-*Shaft of the penis
+*[[Dyspareunia]] in females
-*Head of the penis ([[glans penis]])
-*Opening of the penis (urethral meatus)
-*[[Scrotum]] (least common)
-===Common locations in women===
+==CDC Standard Clinical Definition==
-In women the most common location for ulcers is the [[labia majora]]. "Kissing ulcers" may develop. These are ulcers that occur on opposing surfaces of the labia. Other areas such as the [[labia minora]], [[perineum|perineal]] area, and inner thighs may also be involved. The most common symptoms in women are pain with urination and pain with intercourse.
+The CDC's standard clinical definition for a probable case of chancroid includes all of the following:<ref name="Chancroid CDC">2015 Sexually Transmitted Diseases Treatment Guidelines. Centers for Disease Control and Prevention (June 4, 2015). http://www.cdc.gov/std/tg2015/chancroid.htm Accessed January 21, 2016.</ref>
+*Patient has one or more painful genital ulcers. The combination of a painful ulcer with tender [[adenopathy]] is suggestive of chancroid; the presence of suppurative adenopathy is almost pathognomonic.
-The initial ulcer may be mistaken as a "hard" [[chancre]], the typical sore of primary [[syphilis]], as opposed to the "soft chancre" of chancroid.
+*No evidence of ''[[Treponema pallidum]]'' is indicated by dark-field examination of ulcer or by a serologic test for [[syphilis]] performed at least 7 days after the onset of ulcer.
+*The clinical presentation is not typical of disease caused by [[Herpes Simplex Virus|Herpes Simplex Virus (HSV)]], or result of culture for HSV is negative.
-Approximately one third of the infected individuals will develop enlargements of the [[inguinal]] [[lymph nodes]], the nodes located in the fold between the leg and the lower abdomen.
-Half of those who develop swelling of the inguinal lymph nodes will progress to a point where the nodes rupture through the skin producing draining abscesses. The swollen lymph nodes and abscesses are often referred to as buboes.
 ==References==
 {{Reflist|2}}
-[[Category:Needs content]]
 [[Category:Disease]]
 [[Category:Sexually transmitted diseases]]
 [[Category:Bacterial diseases]]
 [[Category:Proteobacteria]]
-[[Category:Infectious disease]]
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