Chancroid is a sexually transmitted bacterial infection that causes ulceration in the lymph nodes of the groin. This disease is typically found in developing countries, and symptoms tend to vary between men and women. As painful and worrisome as chancroid may be, the prognosis is generally good with proper treatment.

Chancroid

No one wants to deal with painful ulcers in their groin—the issue is delicate and can be downright embarrassing. If you’ve ever had embarrassing pain or sores in your groin area, you’re not alone. There are many conditions that bring about this phenomenon, but chances are if you live in the United States or any other developed nation, you’ve likely never heard of the sexually transmitted infection known as chancroid.

It may be uncommon in the Western world, but it occurs frequently in developing countries, especially among those living in poverty. Though the disease is painful and worrisome, it’s also highly treatable with a good future outlook. This article will cover the definition and history of chancroid, as well as the symptoms, treatment plans, and other important details about the disease.

What is Chancroid?

Chancroid is a type of bacterial sexually transmitted disease (STD) characterized by ulcerous or pus-filled lesions on or around the groin. Its characteristics are highly similar to syphilis, a more well-known STD. Chancroid cases are rarely seen in the United States, but the disease is common in developing nations and impoverished populations. Having this disease increases one’s risk for HIV and AIDS, but there are treatment options available.

Alternative Names

To some, chancroid is known as soft chancre or ulcus molle. Sometimes the disease is simply referred to as genital ulceration. It is important to note that this infection comes in several variations, such as dwarf, in which the ulcer is small and painless; giant, which is self-explanatory in that the ulcer is large and highly developed; and transient, in which the ulcer is superficial, prone to fast healing, and followed by a swelling of the lymph nodes known as a bubo. There are also Serpiginous chancroids, which are multiple ulcers gathered in one area; phagedenic chancroids, a highly destructive version of the disease; and mixed chancroids, which are often seen mixed in with signs of syphilis.

Causes

The infection is caused by a bacterium known as Haemophilus ducreyi, which attacks healthy tissues in the genital area and causes painful open sores and pus-filled blisters. Because chancroid is common in underdeveloped nations, unsanitary living conditions and the popularity of commercial sex workers have contributed to the cause of the disease. Most people who contract the disease get it from visiting countries where the disease is known to occur. Additionally, the disease is commonly associated with crack-cocaine use and prostitution.

Incubation Period of Chancroid

After the H. ducreyi bacteria enters the individual’s bloodstream, signs of the infection will typically begin to appear in four to seven days. The amount of time the infection takes to appear depends on the individual’s health, genetic background, and environmental factors.

How is Chancroid Contracted?

Because this condition is an STD, it is transmitted through sexual contact, though sometimes it can be transmitted by skin-to-skin contact. The H. ducreyi bacteria enters the bloodstream through mircoabrasions that are gained through sexual intercourse. People who are sexually active and who live in or visit countries without proper resources—such as food, water, shelter, and adequate healthcare—are especially at risk for chancroid. Those who are most at risk for contracting the disease include heterosexual males, minorities, people living in poverty, drug and alcohol abusers, and people who partake in high-risk sexual activity with multiple partners.

Symptoms

Chancroid symptoms typically vary between men and women, but both sexes can experience similar warning signs of the disease. How each person experiences their symptoms is dependent on several factors pertaining to the individual’s specific circumstance and background.

In Men

Men who have contracted the disease will first notice painful ulcers on their genitals that eventually turn to open sores after a few days. The ulcers and sores can form anywhere in the groin area, including on the penis, scrotum, and anywhere in the surrounding area. Men will usually experience one or two chancroid ulcers at a time, and they are known to be extremely painful.

In Women

Women who contract chancroid will experience several red bumps on or around the labia, thighs, and anal area. When these bumps turn into ulcers and open sores, women will usually experience pain when urinating. Although women tend to develop more sores while having the disease, they tend to develop fewer symptoms compared to their male counterparts. Women can also develop what is known as follicular chancroid, in which the hair follicles around the pubic area get infected and develop into ulcers.

General symptoms of chancroid include having blisters or ulcers that are painful and jagged, with irregular borders that also have a sense of definition to them. If the ulcer has a yellowish-gray base that bleeds easily when cut or scraped, it is most likely displaying the evidence of having the STD. These symptoms are usually followed by the person developing swollen, painful lymph nodes. People with chancroid may also experience pain during intercourse.

Chancroid Video

Testing

To determine if an individual has chancroid, medical samples are necessary to determine the presence of the H. ducreyi bacteria strain. Because blood testing for this disease is currently not possible, the fluid from the ulcer must be carefully extracted and sent to a laboratory for thorough analysis. In addition to ulcer fluid analysis, the lymph nodes may be to be examined. In less developed nations, this testing may sometimes be unavailable, which is why the persistence of this disease is still rampant in parts of the world.

Treatment

Fortunately, chancroid can easily be cured with medication, surgery, or both. If your doctor recommends the medication route, you will likely be prescribed antibiotics designed to kill ulcer-causing bacteria. Abscesses that have collected excessive fluid are drained by a medical professional. That medical professional will also determine the best course of treatment for the individual depending on the nature, symptoms, and origin of their infection.

Those who should explore every possible option with their doctor include pregnant women, breastfeeding women, and people under 18. If your doctor recommends surgery, chances are the ulcers and swelling in the lymph nodes will be drained. The good thing about chancroid is that it’s highly treatable and reversible if treated regularly and in a timely manner.

Medication Treatment Guidelines for Chancroid STD

Antibiotic:Dose:Route of medication administration:Course of medication:
Azithromycin1000 mgorallyin a single dose
OR
Ciprofloxacin500 mgorallytwice a day for 3 days
OR
Erythromycin500 mgorallythree times a day for 7 days
OR
Ceftriaxone250 mgintramuscularlyin a single dose

Prevention

Preventing chancroid is entirely possible. First, condoms should be used during sex if involving a stranger or paid worker as opposed to a monogamous spouse. This disease occurs frequently in locations with prostitutes and other high sexual activity, and wearing condoms in these cases (or insisting on the use of one if you’re a woman) is one of the most protective, preventative measures you could take.

Another good way to avoid contracting chancroid is to limit the number of sexual partners you have, as well as avoiding all sexually high-risk activities, especially when traveling to or living in developing nations. As a rule of thumb, it is good for sexually active people to get tested for STDs and sexually transmitted infections regularly. Those who test positive for chancroid have a responsibility to tell everyone they’ve been sexually active with or plan on becoming sexually active with to lessen the chance of the disease spreading. Having this STD is unfortunate, but the overall outlook for those who contract it is good and lacks a need for worry.

Dr. Jack Johnson, MD