Chancroid

Chancroid is a bacterial sexually transmitted infection causing painful genital ulcers, more common in some resource-limited settings and associated with an increased risk of HIV transmission.

• One or more painful, soft genital ulcers, typically with ragged edges
• Swollen, sometimes painful lymph nodes in the groin, which can develop into a collection of pus (bubo)
• Ulcers usually appear within about a week of exposure

• Caused by the bacterium Haemophilus ducreyi, transmitted through direct sexual contact with an infected person's ulcer or discharge.
• Presence of genital ulcers, including from chancroid, increases the risk of acquiring or transmitting HIV during sexual contact.

• Often diagnosed clinically based on painful genital ulcers with tender lymph node swelling, particularly where laboratory confirmation is not readily available.
• In many settings, genital ulcers are managed using the syndromic management approach, which covers chancroid along with other common causes of genital ulcers.
• Laboratory testing, where available, can help confirm the specific cause.

An appropriate oral antibiotic — such as azithromycin (single dose) or ciprofloxacin — is effective treatment for chancroid.

Large, fluctuant lymph node swellings (buboes) may need drainage by a health worker in addition to antibiotic treatment.

Sexual partners should be treated at the same time to prevent reinfection and further spread.

Given the link between genital ulcers and HIV transmission, HIV testing is recommended for anyone diagnosed with chancroid.

• Consistent and correct condom use.
• Seek prompt treatment for any genital ulcer rather than waiting for it to heal on its own.
• Ensure sexual partners are treated together.
• Combine STI care with HIV testing given the increased transmission risk associated with genital ulcers.