Chancroid natural history, complications and prognosis: Difference between revisions
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{{Chancroid}} | {{Chancroid}} | ||
{{CMG}}; {{AE}} {{YD}}; {{NRM}}; {{SSK}} | |||
==Overview== | |||
Chancroid symptoms typically develop 4 to 10 days after infection. Initial indication of infection involves formation of erythematous [[papules]] which develop into [[Boil|pustules]] after several days. Approximately 1-2 weeks after pustule formation, the lesions may ulcerate. Patients typically develop 1 to 4 [[ulcers]]. [[Lymphadenopathy]] develops in approximately half of patients, predominantly in males, 1 to 2 weeks after appearance of the primary ulcer. In approximately 25% of patients with lymphadenopathy, lymph nodes may swell to form fluctuant [[Bubo|buboes]] which may rupture and form giant ulcers. Prognosis is poor without treatment. Complications from chancroid include: [[superinfection]] of lesions, extensive [[adenitis]], development of [[inguinal]] [[abscesses]], and nonhealing ulcers. | |||
==Natural History== | |||
*The incubation period for ''H. ducreyi'' is typically 4 to 10 days, after which erythematous [[papules]] arise. | |||
*Approximately 2 to 3 days after symptom onset, papules evolve into [[Boil|pustules]].<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> | |||
*Pustules may resolve spontaneously or ulcerate in approximately 1-2 weeks since formation. Patients typically develop between 1 to 4 [[ulcers]]. | |||
*[[Inguinal]] [[lymphadenitis]] develops in approximately half of patients, usually unilaterally and more commonly in males than females, 1 to 2 weeks after appearance of primary ulcer.<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> | |||
*In approximately 25% of patients with lymphadenitis, lymph nodes may swell to form fluctuant [[Bubo|buboes]]. Untreated buboes may rupture, discharge exudate, and ulcerate.<ref name="Lewis2003" /> | |||
==Complications== | |||
*[[Superinfection]] of lesions by other anaerobic bacteria such as [[Fusobacterium]] and [[Bacteroides]]<ref name="cur">{{cite book|title=CURRENT Diagnosis & Treatment of Sexually Transmitted Diseases|year=2007|publisher=McGraw-Hill Companies,Inc.|isbn=9780071509619|pages=69–74}}</ref><ref name="ChancroidWikipedia">Chancroid. Wikipedia (July 16, 2015). https://en.wikipedia.org/wiki/Chancroid Accessed January 15, 2016.</ref> | |||
*[[Phimosis]] in men<ref name="Lewis2003" /> | |||
*Extensive [[adenitis]] in the absence of treatment | |||
*Development of inguinal [[abscesses]] which may rupture to form a draining [[Sinus (anatomy)|sinus]] or giant ulcer | |||
*Nonhealing ulcers | |||
==Prognosis== | |||
*Chancroid is not lethal. | |||
*Prognosis is poor without treatment. Indications of poor prognosis include: | |||
::Nonhealing ulcers | |||
::[[Lymphadenopathy]], especially with the formation and/or rupture of [[Bubo|buboes]] | |||
::[[Superinfection]] of lesions (phagedenic chancroid) | |||
==References== | ==References== | ||
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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
Chancroid symptoms typically develop 4 to 10 days after infection. Initial indication of infection involves formation of erythematous papules which develop into pustules after several days. Approximately 1-2 weeks after pustule formation, the lesions may ulcerate. Patients typically develop 1 to 4 ulcers. Lymphadenopathy develops in approximately half of patients, predominantly in males, 1 to 2 weeks after appearance of the primary ulcer. In approximately 25% of patients with lymphadenopathy, lymph nodes may swell to form fluctuant buboes which may rupture and form giant ulcers. Prognosis is poor without treatment. Complications from chancroid include: superinfection of lesions, extensive adenitis, development of inguinal abscesses, and nonhealing ulcers.
Natural History
- The incubation period for H. ducreyi is typically 4 to 10 days, after which erythematous papules arise.
- Approximately 2 to 3 days after symptom onset, papules evolve into pustules.[1]
- Pustules may resolve spontaneously or ulcerate in approximately 1-2 weeks since formation. Patients typically develop between 1 to 4 ulcers.
- Inguinal lymphadenitis develops in approximately half of patients, usually unilaterally and more commonly in males than females, 1 to 2 weeks after appearance of primary ulcer.[2]
- In approximately 25% of patients with lymphadenitis, lymph nodes may swell to form fluctuant buboes. Untreated buboes may rupture, discharge exudate, and ulcerate.[2]
Complications
- Superinfection of lesions by other anaerobic bacteria such as Fusobacterium and Bacteroides[3][4]
- Phimosis in men[2]
- Extensive adenitis in the absence of treatment
- Development of inguinal abscesses which may rupture to form a draining sinus or giant ulcer
- Nonhealing ulcers
Prognosis
- Chancroid is not lethal.
- Prognosis is poor without treatment. Indications of poor prognosis include:
- Nonhealing ulcers
- Lymphadenopathy, especially with the formation and/or rupture of buboes
- Superinfection of lesions (phagedenic chancroid)
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 2.2 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.
- ↑ CURRENT Diagnosis & Treatment of Sexually Transmitted Diseases. McGraw-Hill Companies,Inc. 2007. pp. 69–74. ISBN 9780071509619.
- ↑ Chancroid. Wikipedia (July 16, 2015). https://en.wikipedia.org/wiki/Chancroid Accessed January 15, 2016.