H. aegyptius and H. ducreyi

Soft chancre

Chancroid

Ans. is ‘a’ i.e., Hemophilus ducreyi; ‘c’ i.e., Donovani granulomatis

Ans. is ‘a’ i.e., Hemophilus ducreyi

Characteristic of Genital ulcers seen in Hemophilus Duero/

No of lesions                          —> Multiple

Pain                                          —> Present, usually very tender

Base                                         —> Purulent, bleeds easily

Depth                                       —> Excavated

Edges                                       —> Undermined ragged irregular

Lymphadenopathy              —> Tender, may suppurate, loculated usually unilateral.

A i.e. Hemophilus ducreyi

B i.e. Hemophillus

Ans. B i.e. Haemophilus 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.

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.

Chancroid (also known as soft chancre and ulcus molle) is a bacterial sexually transmitted infection characterized by painful sores on the genitalia. Chancroid is known to spread from one individual to another solely through sexual contact.Chancroid is a lesion typical of infection with the bacterium Haemophilus ducreyi. Chancres are typically painless, whereas chancroid are typically painful.

The appearance shown in the microphotograph above resembles school of fish appearance or rail road track appearance shown by Hemophilus ducreyi.

Haemophilus ducreyi is a fastidious gram-negative coccobacillus bacteria, which causes the sexually transmitted disease chancroid, a major cause of genital ulceration in developing countries characterized by painful sores on the genitalia. 

Ans:D.)All of the above.

Inguinal Bubo.

• Inguinal and femoral buboes are localised enlargements of the lymph nodes in the groin area, which are painful and may be fluctuant.
• They are frequently associated with lymphogranuloma venereum and chancroid..

Lymphogranuloma venereum (LGV)

• It is a sexually transmitted disease caused by the invasive serovars L1, L2, L2a or L3 of Chlamydia trachomatis.
  • Inoculation at the mucous lining of external sex organs (penis and vagina) can lead to the inguinal syndrome named after the formation of buboes or abscesses in the groin (inguinal) region where draining lymph nodes are located.
• Primary stage:LGV may begin as a self-limited painless genital ulcer that occurs at the contact site 3–12 days after infection.
• The secondary stage most often occurs 10–30 days later.
  • The infection spreads to the lymph nodes through lymphatic drainage pathways.
  • The most frequent presenting clinical manifestation of LGV among malesis unilateral (in 2/3 of cases) lymphadenitis and lymphangitis, often with tender inguinal and/or femoral lymphadenopathy .
  • Lymphangitis of the dorsal penis may also occur and resembles a string or cord.
  • If the route was anal sex the infected person may experience lymphadenitis and lymphangitis and proctitis.
  • In females, cervicitis, perimetritis, or salpingitis may occur as well as lymphangitis and lymphadenitis in deeper nodes.
• Treatment involves antibiotics(Tetracycline/Doxycycline,Erythromycin/Azithromycin) and may involve drainage of the buboes or abscesses by needle aspiration or incision.

Chancroid

• Chancroid is a sexually transmitted disease caused by the fastidious Gram-negative streptobacillus Haemophilus ducreyi.
• H. ducreyi enters skin through microabrasions incurred during sexual intercourse. A local tissue reaction leads to development of erythomatous papule, which progresses to pustule in 4–7 days. It then undergoes central necrosis to ulcerate.
• Painful lymphadenopathy occurs in 30 to 60% of patients.
• Treatment is a single oral dose (1 gram) of azithromycin, or a single IM dose of ceftriaxone, or oral erythromycin for seven days.