Chancroid physical examination: Difference between revisions

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Revision as of 14:38, 22 January 2016

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]

Erythematous papules
Pustules
Ulcers

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

Foreskin (prepuce) (most common)^[6]
Groove behind the head of the penis (coronal sulcus)
Shaft of the penis
Head of the penis (glans penis)
Opening of the penis (urethral meatus)
Scrotum (least common)

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)

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

Chancroid. Adapted from Dermatology Atlas.^[8]
Chancroid. Adapted from Dermatology Atlas.^[8]
Chancroid. Adapted from Dermatology Atlas.^[8]
Chancroid. Adapted from Dermatology Atlas.^[8]
Chancroid. Adapted from Dermatology Atlas.^[8]
Chancroid. Adapted from Dermatology Atlas.^[8]
Chancroid. Adapted from Dermatology Atlas.^[8]
Chancroid. Adapted from Dermatology Atlas.^[8]
Chancroid. Adapted from Dermatology Atlas.^[8]
Chancroid infection has spread to the inguinal lymph nodes, which have enlarged forming buboes.
Penile chancroid lesion.

References

↑ 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.
↑ 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.
↑ Chancroid. UpToDate (September 25, 2015). http://www.uptodate.com/contents/chancroid#H3 Accessed January 19, 2016.
↑ 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.
↑ Chancroid. Wikipedia (July 16, 2015). https://en.wikipedia.org/wiki/Chancroid Accessed January 15, 2016.
↑ ^6.0 ^6.1 Chancroid. MedlinePlus (January 13, 2016). https://www.nlm.nih.gov/medlineplus/ency/article/000635.htm Accessed January 21, 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.
↑ ^8.0 ^8.1 ^8.2 ^8.3 ^8.4 ^8.5 ^8.6 ^8.7 ^8.8 "Dermatology Atlas".

[pmid25271477-1] 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.

[pmid25774793-2] 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.

[ChancroidUpToDate-3] Chancroid. UpToDate (September 25, 2015). http://www.uptodate.com/contents/chancroid#H3 Accessed January 19, 2016.

[Spinola2002-4] 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.

[ChancroidWikipedia-5] Chancroid. Wikipedia (July 16, 2015). https://en.wikipedia.org/wiki/Chancroid Accessed January 15, 2016.

[ChancroidMedline-6] 6.0 ^6.1 Chancroid. MedlinePlus (January 13, 2016). https://www.nlm.nih.gov/medlineplus/ency/article/000635.htm Accessed January 21, 2016.

[Lewis2003-7] 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.

[Dermatology_Atlas-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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@@ Line 39: / Line 39: @@
 *[[perineum|Perineal]] area
 *Inner thighs (least common)
-===Extremities===
-Ulcers may be found on extremities in cases .
 ===Other Signs===