Chancroid
Chancroid is caused by?
| A | H. Ducrei | |
| B |
N. Gonnorrea |
|
| C | T. Pallidum | |
| D |
H. Influenza |
Chancroid is caused by?
| A |
H. Ducrei |
|
| B |
N. Gonnorrea |
|
| C |
T. Pallidum |
|
| D |
H. Influenza |
Ans:A.)H. Ducrei
CHANCROID (SOFT SORE)
This venereal infection is caused by the Gram-negative bacillus Haemophilus ducreyi. One to 5 days post-infection, a soft sloughy ulcer appears on the penis or vulva. The treatment of choice is erythromycin (500 mg 6-hourly for 14 days).
| A | H. ducreyi | |
| B | H. influenzae | |
| C | H. aprophilus | |
| D | All the above |
Tender Bubos seen are used in the diagnosis of:
| A | Gonorrhoea | |
| B | Herpes | |
| C | Chancroid | |
| D | Granuloma venereum |
Which of the following is the causative organism for Chancroid?
| A |
Haemophilus ducreyi |
|
| B |
Haemophilus influenza |
|
| C |
Treponema pallidum |
|
| D |
Neisseria Gonorrhea |
Haemophilus ducreyi, a gram-negative, facultative anaerobic coccobacillus is the causative agent of Chancroid.
Painful, soft ulcers with ragged undermined margins develop 1–2 weeks after inoculation (usually seen in prepuce and frenulum in men and vulva, cervix, and perianal area in women).
Must Know:
- Chancroid facilitates the transmission of HIV.
- Azithromycin and Ceftriaxone are recommended as single-dose treatment.
- It is a sexually transmitted disease, but nonsexual transmission has been reported recently.
Ref: Lautenschlager S. (2012). Chapter 202. Chancroid. In L.A. Goldsmith, S.I. Katz, B.A. Gilchrest, A.S. Paller, D.J. Leffell, N.A. Dallas (Eds), Fitzpatrick’s Dermatology in General Medicine, 8e.
| A | Gonorrhoea | |
| B |
Herpes |
|
| C |
Chancroid |
|
| D |
Granuloma venereum |
Incubation period of chancroid is:
| A |
< 7 days |
|
| B |
10-14 days |
|
| C |
2-3 weeks |
|
| D |
3-4 weeks |
Chancroid: caused by Hemophilus ducreyi
- Incubation period is 4 to 7 days
- Azithromycin is drug of choice
| A |
T. pallidium |
|
| B |
G. donovani |
|
| C |
Chlamydia Trachomatis |
|
| D |
Herpes Hominis Virus |
D i.e. Herpes virus – hominis
Reliable test for chancroid detection-
| A |
Skin test |
|
| B |
Biopsy |
|
| C |
Grams stained smear |
|
| D |
Clinical examination |
C i.e. Grams stained smear
DOC in chancroid is
| A |
Tetracycline |
|
| B |
Doxycycline |
|
| C |
Erythromycin |
|
| D |
Streptomycin |
C i.e. Erythromycin
Distinguishing Features of Genital Ulcers
|
Features |
Syphilis (1°chancre) |
Chancroid (soft chancre) |
Lymphogranuloma Venereum |
Donovanosis Granuloma venerum/inguinale) |
Herpes genitalis |
|
Causative agent |
Treponema |
Haemophilus |
Chlamydia |
Calymmatobacterium |
Herpes simplex |
|
|
pallidiumQ |
ducreyiQ |
trachomatisQ |
granulomatisQ |
virus type HQ |
|
|
|
|
(LI,L2,L3) |
|
(rarely type I) |
|
Incubation period |
9 – 90 daysQ |
1 – 7 days rarely > 10 days |
3 days – 6 weeks |
1-4 weeks (upto 6 months) |
2-7 days |
|
No. of attacks |
Only one (1) |
1 or 2 |
Only one (1) |
Only one (1) |
Reccurent |
|
No. of lesions |
Usually 1 |
Usually multipleQ may coalesce |
Usually 1 |
Variable |
MultipleQ, may coalesce |
|
Early 1° lesion |
Papule |
Pustule |
Papule, pustule |
Papule |
VesicleQ |
|
Diameter |
5-15 mm |
Variable |
2-10 mm |
Variable |
1-2 mm |
|
Depth |
Superficial or deep |
Excavated |
Superficial or deep |
Elevated |
Superficial |
|
Edges |
Sharply demarcated, elevated, round or oval |
Undermined, ragged, sloughedQ irregular |
Elevated, round or oval |
Elevated, irregular serpiginous |
Erythematous |
|
Base |
Smooth, non- purulent, non- vascula,Q (relatively) |
Purulent, bleeds easily |
Variable, nonvascular |
Red & velvety (beefy red), bleeds easily with exuberant granulation tissueQ |
Serous, erythematous, nonvascular. |
|
Induration |
FirmQ |
SoftQ (mostly) |
Occasionly firm |
Firm |
None |
|
Pain |
UncommonQ |
Usually very tender |
Variable |
Uncommon |
Frequenctly tenderQ |
|
Lymphadenopathy |
Firm, non tender, shotty, bilateralQ |
Tender, may suppurate, loculated, usually unilateral (Bubo) |
Tender, may suppurate, loculated, usually unilateral (Bubo) |
No lymphadenopathy pseudobuboesQ (subcutaneous nodules in inguinal region, may ulcerate) |
Firm, tender, often bilateral |
|
Diagnosis |
– Dark field |
– Clinical features |
– Demonstration of |
– On tissue smear & |
– Multinucleate |
|
|
microscopyQ – Serologicaltests |
– Gram staining (gram -ve cocco- baccili with rail road appearance) |
LGV as elementary & inclusion bodies – Frie’s testQ – Hyper gamma- globulinemia – Complement fixation +ve |
histopathological microscopy using Giemsa, Wrights or Silver stain or Leishman Stain 1. Gram negative C. granulomatis may be seen within characteristic large mono nuclear cell as |
d giant cell on Tzank smear – Culture is confirmatory |
|
|
|
|
|
Donovan bodies |
|
|
|
|
|
|
2. Donovan bodies are seen in vacuolated cytoplasm of large mono nuclear cells as bipolar inclusionsQ |
|
|
|
|
|
|
(safety pin or telephone handle appearance) measuring 1 to 2 um x |
|
|
|
|
|
|
0.5 to 0.7 um. |
|
|
Drug |
– Benzathine/procaine |
– Azithro/ |
– Doxy / tetra |
DoxycyclineW tetracycline |
AcyclovirQ |
|
|
Penicillin in all |
erythromycin |
cyclineQ |
Azithromycin / |
|
|
|
except neurosyph- ilis & congenital syphilis in which crystalline penicillin |
– Ciftriaxone . – Ciprofloxacin |
– Erythromycin |
erythromycin (in pregnancy) |
|
|
|
(aqueous benzyl penicillin) is used |
|
|
|
|
|
|
– In penicillin sensitive patient, Tetracycline or erythromycin is used |
|
|
|
|
| A | Chancroid | |
| B |
Primary chancre |
|
| C |
Herpes genitalisLGV |
|
| D |
All |
A i.e. Chancroid
Painful lymphadenopathy is seen in:
| A |
Donovanosis |
|
| B |
Syphilis |
|
| C |
Chancroid |
|
| D |
All |
C i.e. Chancroid
Syndromic Management of genital ulcer syndrome in India includes
| A |
Chancroid and Primary chancre |
|
| B |
Chancroid and herpes simplex |
|
| C |
Chancroid, Primary Chancre and herpes simplex |
|
| D |
Herpes simplex and primary chancre |
C i.e. Chancroid, Primary Chancre and herpes simplex
STDs presenting with genital ulcers include herpes genitalis (by HSV typell), primary syphilis (primary chncre), chancroid and donovanosisQ. And syndromic management of genital ulcers include if vesicle or multiple painful ulcers.
Chancroid is caused by:
September 2005
| A |
Herpes simplex virus |
|
| B |
HPV |
|
| C |
T. pallidum |
|
| D |
H.ducreyi |
Ans. D: H.Ducreyi
Most people with chancroid will develop one or more red, inflamed lumps in the genital area 3-7 days after being infected during sexual intercourse.
These become larger and pus-filled until they rupture, leaving a painful ulcer.
If left untreated, 50% of cases develop infected lymph glands, which become large, hard painful lumps (buboes), on either one or both sides of the groin.
The site of most infections in men is the foreskin but other parts of the penis may be affected.
In women, ulcers may be located on the labia, thigh, perineum and cervix.
Women generally have less specific symptoms such as painful urination or pain on passing bowel motions (defaecation), vaginal discharge, painful sexual intercourse (dyspareunia) and rectal bleeding.
