Chancroid history and symptoms: Difference between revisions
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Revision as of 15:37, 21 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. Nawal Muazam M.D.[2] Serge Korjian M.D.
Overview
The characteristic lesion in chancroid is a painful, nonindurated ulcer. In men the most common site of this ulcer is the perpuce and in women the labia majora.
Symptoms
After an incubation period of 4 to 10 days, chancroid begins with a small bump that may ulcerate within several days to weeks. 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.
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.
Common locations in men (from most common to least common)
- Foreskin (prepuce) (most common)
- 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 women
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, perineal area, and inner thighs may also be involved. The most common symptoms in women are pain with urination and pain with intercourse.
The initial ulcer may be mistaken as a "hard" chancre, the typical sore of primary syphilis, as opposed to the "soft chancre" of chancroid.
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