Chancroid physical examination: Difference between revisions

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===Skin===
===Skin===
A patient may present with either of the following types of lesions on the genitals, depending on the stage of infection:<ref name="ChancroidUpToDate">Chancroid. UpToDate (September 25, 2015). http://www.uptodate.com/contents/chancroid#H3 Accessed January 19, 2016.</ref><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>
A patient may present with either of the following types of lesions on the genitals (or extremities in cases of cutaneous limb ulcers<ref name="pmid25271477">{{cite journal| author=Marks M, Chi KH, Vahi V, Pillay A, Sokana O, Pavluck A et al.| title=Haemophilus ducreyi associated with skin ulcers among children, Solomon Islands. | journal=Emerg Infect Dis | year= 2014 | volume= 20 | issue= 10 | pages= 1705-7 | pmid=25271477 | doi=10.3201/eid2010.140573 | pmc=PMC4193279 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25271477}}</ref><ref name="pmid25774793">{{cite journal| author=Gaston JR, Roberts SA, Humphreys TL| title=Molecular phylogenetic analysis of non-sexually transmitted strains of Haemophilus ducreyi. | journal=PLoS One | year= 2015 | volume= 10 | issue= 3 | pages= e0118613 | pmid=25774793 | doi=10.1371/journal.pone.0118613 | pmc=PMC4361675 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25774793  }} </ref>), depending on the stage of infection:<ref name="ChancroidUpToDate">Chancroid. UpToDate (September 25, 2015). http://www.uptodate.com/contents/chancroid#H3 Accessed January 19, 2016.</ref><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]]
*Erythematous [[papules]]
*[[Boil|Pustules]]
*[[Boil|Pustules]]
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*[[perineum|Perineal]] area
*[[perineum|Perineal]] area
*Inner thighs (least common)
*Inner thighs (least common)
===Extremities===
Ulcers may be found on extremities in cases .


===Other Signs===
===Other Signs===
*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>
*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>
*Approximately 25% of patients with lymphadenopathy may present with abscesses in lymph nodes or ruptured buboes
*Approximately 25% of patients with lymphadenopathy may present with abscesses in lymph nodes or ruptured buboes


==Gallery==
==Gallery==

Revision as of 14:37, 22 January 2016

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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

Physical Examination

Vital Signs

Typically normal

Skin

A patient may present with either of the following types of lesions on the genitals (or extremities in cases of cutaneous limb ulcers[1][2]), depending on the stage of infection:[3][4]

Ulcer characteristics:[5]

  • 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
  • Males typically have a single ulcer
  • Females typically have multiplee ulcers
  • May look similar to syphilitic chancre

Common locations in males

Common locations in females

  • labia majora (most common). "Kissing ulcers" may develop, defined as ulcers that occur on opposing surfaces of the labia.[6]
  • labia minora
  • Perineal area
  • Inner thighs (least common)

Extremities

Ulcers may be found on extremities in cases .

Other Signs

  • Inguinal lymphadenitis in approximately 50% of patients, known as buboes (typically unilateral and predominantly in males)[7]
  • Approximately 25% of patients with lymphadenopathy may present with abscesses in lymph nodes or ruptured buboes

Gallery

References

  1. ↑ Marks M, Chi KH, Vahi V, Pillay A, Sokana O, Pavluck A; et al. (2014). "Haemophilus ducreyi associated with skin ulcers among children, Solomon Islands". Emerg Infect Dis. 20 (10): 1705–7. doi:10.3201/eid2010.140573. PMC 4193279. PMID 25271477.
  2. ↑ Gaston JR, Roberts SA, Humphreys TL (2015). "Molecular phylogenetic analysis of non-sexually transmitted strains of Haemophilus ducreyi". PLoS One. 10 (3): e0118613. doi:10.1371/journal.pone.0118613. PMC 4361675. PMID 25774793.
  3. ↑ Chancroid. UpToDate (September 25, 2015). http://www.uptodate.com/contents/chancroid#H3 Accessed January 19, 2016.
  4. ↑ 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.
  5. ↑ Chancroid. Wikipedia (July 16, 2015). https://en.wikipedia.org/wiki/Chancroid Accessed January 15, 2016.
  6. ↑ 6.0 6.1 Chancroid. MedlinePlus (January 13, 2016). https://www.nlm.nih.gov/medlineplus/ency/article/000635.htm Accessed January 21, 2016.
  7. ↑ 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.
  8. ↑ 8.0 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 "Dermatology Atlas".
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