The Occurrence of Chancroid

by Michael_Koger

The occurrence of chancroid has had the attention of doctors across the globe for more than a century.

When partners touch each other, the transmission of disease varies with the type of physical interaction between two individuals as well as the responsible microorganism. For example, it is well-known that hepatitis A and hepatitis B spread from one human to another via blood and body fluids in a variety of ways. Some microbes, however, spread via skin-to-skin contact. These include syphilis, chancroid, and genital herpes [1, 2].

Secondary syphilis may present with skin lesions on the palms of the patient’s hands. Though the skin lesions of chancroid resemble those of syphilis or even genital herpes, these three illnesses are unique. Genital herpes may spread via sexual intercourse as well as contact between the thighs and other areas of the body.
[1, 2, 3, 4].

Disease Occurrence

     The microorganism responsible for chancroid is Haemophilus ducreyi.  It is a fastidious Gram- negative bacterium.  Fastidious means that the microbe requires a complex nutritional regimen.  The chancre of syphilis and the skin lesions of chancroid are not identical.  Chancroid skin ulcers may be painful, and inflammation of lymph nodes in the groin area is common [1, 2, 3, 4, 5].

     The worldwide occurrence of chancroid has never been well-known.  It is obvious, however, that it has been common in Africa, Asia, and the Caribbean.  In some areas of the globe, it is endemic or continuously present.  It is also evident that the occurrence of chancroid is especially high when human immunodeficiency virus infection is common.  Also, the condition is more likely to spread when the male partner has never undergone circumcision [1, 2, 3, 4].

     As with any condition that spreads through sex, chancroid especially takes place in men who spend time with prostitutes.

     Nevertheless, these statistics have changed over the decades with some improvement in disease occurrence.  Specifically, Europe and North America have demonstrated decline in occurrence of it, but poor countries still have a public health problem with chancroid [1, 2, 3, 4]. 

Diagnostic Dilemma

     A major issue with control of chancroid is the lack of laboratory equipment to make a reasonable diagnosis.  In essence, the culture media to identify this infirmity are not present in some countries.  Even when the necessary tools are available, the sensitivity may only be 80 per cent.

Clinical Management

     There are antimicrobial protocols which can lead to microbiologic cure [4].  These agents include azithromycin, ceftriaxone, ciprofloxacin, or erythromycin.  For pregnant women, ciprofloxacin is not the drug of choice.  Moreover, clients who are HIV-positive may not progress as quickly with treatment as those who are HIV-negative.  Naturally, non-compliance with medication will hamper progress with management.  It also follows that whenever an individual acquires chancroid, adequate treatment of sexual partners is necessary.

Conclusion

     The management of all sexually transmitted infections requires an experienced team.  Adequate tools to diagnose and manage the infirmities which are present will enable the medical community to solve this worldwide public health issue.  

References

  1. González-Beiras, C., Marks, M., Chen, C. et al.  (2016).  Epidemiology of Haemophilus ducreyi infections.  Emerging Infectious Diseases, 22, 1-8.
  2. Centers for Disease Control and Prevention.  (2018).  Sexually transmitted diseases (STDs). 
  3. Steen, R.  (2001).  Eradicating chancroid.  Bulletin of the World Health Organization, 79, 818-826.
  4. Centers for Disease Control and Prevention.  (2015).  2015 Sexually Transmitted Diseases Treatment Guidelines.  Chancroid.
  5. Merriam-Webster Online.  (2018).
  6. Copyright 2018.  Michael Koger, Sr.  All rights reserved.

Disclaimer

     The information contained in this article is for educational purposes only, and one should not use it for diagnosis or treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact their physician for advice.

Updated: 12/23/2018, Michael_Koger
 
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