Chancroid  

comprehensive information on chancroid symptoms, treatment, prevention and more.

　
What is chancroid?
Chancroid is a highly contagious yet curable sexually transmitted disease (STD) caused by the bacteria Haemophilus Ducreyi [hum-AH-fill-us DOO-cray]. Chancroid causes ulcers, usually of the genitals. Swollen, painful lymph glands, or inguinal buboes [in-GWEEN-al BEW-boes], in the groin area are often associated with chancroid. Left untreated, chancroid may facilitate the transmission of HIV.
Transmission
Chancroid is transmitted in two ways:
  • sexual transmission through skin-to-skin contact with open sore(s).
  • non-sexual transmission by means of autoinoculation when contact is made with the pus-like fluid from the ulcer.
A person is considered to be infectious when ulcers are present. There has been no reported disease in infants born to women with active chancroid at time of delivery.

Chancroid symptoms
  • Symptoms usually occur within 10 days from exposure. They rarely develop earlier than three days or later than 10 days.
  • The ulcer begins as a tender, elevated bump, or  papule, that becomes a pus-filled, open sore with eroded or ragged edges.
  • It is soft to the touch (unlike a Syphilis chancre that is hard or rubbery). The term soft chancre is frequently used to describe the chancroid sore.
  • The ulcers can be very painful in men but women are often unaware of them.
  • Because chancroid is often asymptomatic in women, they are often unaware of the lesion(s).
  • Painful lymph glands may occur in the groin, usually only on one side; however, they can occur on both sides.
  • Up to 75% of women have no symptoms when infected with Chlamydia, so testing for Chlamydia is the only way to be sure that you are not infected. When symptoms do occur in women they can include:
    • a burning feeling when urinating
    • change in periods, or more painful periods
    • bleeding or blood spotting from the vagina
    • pain during sex
    • pain in the lower stomach area
    • need to urinate more often
    • slight fever
  • Estimates vary on how many men with Chlamydia have no symptoms, but it is probably about half. Symptoms may be mild and can include:
    • abnormal fluid from penis
    • pain with urination
    • an itching feeling inside the penis . This may be a tingling or itch in the urethra; sometimes referred to as "urethral awareness".
    • need to urinate more often
  • Chlamydia can also infect the rectum through rectal intercourse, and cause no symptoms. If there are symptoms, they are the same as those for gonorrhea and may include:
    • discharge from the rectum
    • rectal pain
    • mucous with stools
    • painful bowel movements
    • anal lesions
    • redness in the anal area

　

Chancroid treatment
Chancroid can be treated with antibiotics. Successful treatment:
  • cures infection
  • resolves symptoms
  • prevents transmission

　
Treatment regimens may include the following:
  • Azithromycin
  • Ceftriaxone
  • Ciprofloxacin (not recommended for pregnant or nursing females, or people younger than 18 years.)
  • Erythromycin base

　
A follow-up examination should be conducted three to seven days after treatment begins. If treatment is successful, ulcers usually improve within three to seven days. The time required for complete healing is related to the size of the ulcer. Large ulcers may require two weeks or longer to heal. In severe cases, scarring may result. Partners should be examined and treated regardless of whether symptoms are present.
What if I don't get it treated?
If chlamydia remains untreated, you may have the following:

　

Chancroid Prevention information
  • Abstinence (not having sex)
  • Mutual monogamy (having sex with only one uninfected partner)
  • Water-based spermicides can be used along with latex condoms for additional protection during vaginal intercourse. Use of spermicide is not recommended nor found to be effective for oral or anal intercourse.
  • Latex condoms for vaginal, oral and anal sex. Using latex condoms may protect the penis or vagina from infection, but does not protect other areas such as the scrotum or anal area.

　
If you do get chancroid, avoid contact with the infected area to prevent chance of autoinoculation.
Why worry?
Chancroid had been well established as a cofactor for HIV transmission. Moreover, persons with HIV may experience slower healing of chancroid, even with treatment, and may need to take medications for a longer period of time. Complications from changroid include:
  • In 50 percent of cases, the lymph node glands in the groin become infected within five to eight days of appearance of initial sores.
  • Glands on one side become enlarged, hard, painful and fuse together to form a bubo (BEW-bo), an inflammation and swelling of one or more lymph nodes with overlying red skin. Surgical drainage of the bubo may be necessary to relieve pain.
  • Ruptured buboes are susceptible to secondary bacterial infections.
  • In uncircumcised males, new scar tissue may result in phimosis (constriction so the foreskin cannot be retracted over the glans). Circumcision may be required to correct this.

　
Partner communication
You should talk to your partner as soon as you learn you have chancroid. Telling a partner can be hard, but it's important that you talk to your partner as soon as possible so she or he can get treatment.
Provider communication
If you have a genital ulcer or painful, swollen lymph nodes, you may need to talk to your doctor about whether or not you should be tested. However, it's important to remember that some people, usually women, are asymptomatic. If you are having unprotected sex or discover that your partner is having unprotected sex with another person, you may want to ask your doctor about being tested.
How do you get it?
The bacteria, Chlamydia trachomatis (CT) is passed between people by direct contact with infected sexual fluids from the genitals. Actual penetration is not necessary for the bacteria to be transmitted. Close contact like rubbing between a penis and vagina, or a penis and penis prior to condom use, or masturbation with the sexual fluids of another person may be enough to transmit the bacteria if one partner has the infection. If the bacteria from the genitals is rubbed into the eye, it is possible but not common, to get an eye infection (conjunctivitis). The eye infection causes itchiness and blurred vision.
Chlamydia can also be spread from an infected woman's cervix to a baby during delivery. All babies in BC are treated with erythromycin eye drops after delivery to prevent the possibility of an eye infection.

How common is it?
Chlamydia is the most common bacterial STD in Canada. This infection is most common in sexually active adults under 25 yrs. In BC in 2000, there were 6,193 cases of chlamydia reported. This means a rate of 152.3 per 100,000 people. This remains higher than the Canadian rate of 141.8. Since 1997, the chlamydia rate in BC has been increasing. Female case numbers are more than double the number of male cases. This may be due to lower rates of chlamydia screening in men compared to women.
Chlamydia in Pregnancy
Some antibiotics are not to be taken during pregnancy. It is important to let your health care provider know if you are pregnant and have tested positive for chlamydia. Your partner needs to be treated as well, with a repeat test 3-4 weeks after treatment to make sure the chlamydia is gone.
Infection during pregnancy can cause spontaneous abortion (miscarriage), infection of the placenta/amniotic sac (membrane surrounding baby), premature delivery, low birth weight babies and infection (eyes, lungs, ears) in the newborn.

Chancroid links
Chlamydia - The Silent Epidemic - Information from the US-based Arnot Ogden Medical Center.

   More information


If you have additional questions about chancroid, call the CDC National STD and AIDS Hotlines at 1-800-342-2437 or 1-800-227-8922. The hotlines are open 24 hours a day, seven days a week. For information in Spanish call 1-800-344-7432, 8:00 AM to 2:00 AM Eastern Time, seven days a week. For the Deaf and Hard-of-Hearing call 1-800-243-7889, 10:00 AM to 10:00 PM Eastern Time, Monday through Friday.