Chancroid: Symptoms, Diagnosis, and Antibiotic Treatment

Chancroid is an acute, sexually transmitted genital ulcer disease caused by Haemophilus ducreyi (Gram-negative coccobacillus).

Clinical Features (Incubation 3–10 days)

• Ulcers: 1–multiple, painful, soft, non-indurated, ragged edges, friable base with gray-yellow exudate. Bleed easily.
• Location: Penis (prepuce, coronal sulcus), vulva, perineum, anus.
• Buboes: Suppurative inguinal lymphadenopathy (50%), often unilateral, may fluctuate/rupture.
• Systemic symptoms rare (low-grade fever, malaise).

Diagnosis

• Clinical syndrome + exclusion of syphilis (dark field/RPR), HSV (PCR/culture).
• Definitive: Culture on chocolate agar (fastidious) or PCR (not widely available).

Treatment (CDC Guidelines)

• Azithromycin 1 g PO single dose (preferred).
• Ceftriaxone 250 mg IM single dose.
• Ciprofloxacin 500 mg PO BID ×3 days.
• Erythromycin 500 mg PO TID ×7 days (less effective, GI side effects).

Adjunctive Care

• Incision/drainage of fluctuant buboes (with antibiotics).
• Pain control, wound care.
• Partner notification/treatment.
• HIV/syphilis testing.