Microbiology & Parasitology

CHANCROID
and
GENITAL HERPES

Submitted by:

Rea Kristel Malapitan

Kyla Ramones
Chancroid
The etiologic agent is Haemophilus ducreyi, a
gram-negative coccobacillus. Haemophilus means
“blood-loving” and must be grown in culture medium
containing blood. It only requires hemin (X factor) for
growth which is derived from the blood in the culture
medium.

Clinical Findings
Chancroid presents with a soft, painful papule with
an erythematous base that develops into an ulcer with
ragged edges associated with inguinal
lymphadenopathy.

Laboratory Diagnosis
Definitive diagnosis is made through culture on at
least two kinds of enriched media containing
vancomycin.
Treatment and Preventions
Antibiotics for treatment include cephalosporins,
azithromycin, erythromycin, or ciprofloxacin.

Genital Herpes
Genital Herpes is caused by Herpes Simplex Virus
(HSV). It is a DNA virus under the family of Human
Herpesviridae. There are two types of HSV, type 1 and
type 2. The virus is capable of latency in the neurons
hence the occurrence of recurrent infections.
Mode of Transmission
The main domain of transmission is through oral
secretions or sexual contact.

Clinical Findings
Genital Herpes is caused by HSV types 1 and 2, but
majority cases are caused by type 2. Most primary
infections are asymptomatic.
The lesions are vesicular which later on rupture
resulting to ulcers and are painful with inguinal
lymphadenopathy. The lesions are seen in the vulva,
vagina, cervix, or perianal area and are accompanied by
pruritus and mucoid vaginal discharge.
 Recurrent infections are often of shorter duration
and less severe than the primary infection. A
consequence of genital herpes in newborns is neonatal
herpes which is acquired in utero or upon passage
through the infected birth canal during delivery.
Laboratory Diagnosis
Tzanck smear and histopathologic examination are
done to demonstrate the characteristic cytopathologic
effects that includes Cowdry type A inclusions, syncytia
formation, and ballooning of infected cells. A more
specific diagnostic test is PCR or immunofluorescence.

Treatment and Prevention

The drug of choice is acyclovir but it does not
prevent recurrences. The prevention is the same as with
other sexually transmitted diseases. No vaccine is
available.
Comparison of the major genital sore
diseases
Primary Genital Chancroid
Syphilis Herpes
Etiologic Treponema Herpes Haemophilus
Agent pallidum Simplex ducreyie
Virus
Incubation 3 weeks (10- 2-7 days 3-5 days
Period 90 days)

Usual Slightly tender Marked Tender

clinical papule that pain in papulae
presentation ulcerates over genital that
1 to several area; ulcerates
weeks
papules
ulcerate in
3-6 days;
fever,
headache,
malaise
and
inguinal
adenopath
y common
Diagnostic Dark-filled Virus culture Culture in at
tests exam of of cells and least two
exudate from fluid from kinds of
chancre; chancre; enriched
serologic tests nucleic acid media with
amplification vancomycin
tests
Long-term Secondary Recurrent Inguinal bubo
sequelae syphilis with genital
mucocutaneou herpes
s lesions;
tertiary
syphilis
Treatment Benzathine Acyclovir Ceftriaxone,
penicillin G; famciclovir azithromycin,
 doxycycline if or erythromycin
allergic to valacyclovir , or
penicillin ciprofloxacin

Terminologies
Haemophilus Ducreyi- It causes the sexually transmitted
disease chancroid, a major cause of genital ulceration in
developing countries characterized by painful sores on the
genitalia.
Ulcer- an open, painful sore.
Inguinal Lymphadenopathy- is a nonspecific finding that is
characteristic of inflammatory pathology almost anywhere in
the groin or either lower extremity.
Vancomycin- is a glycopeptide antibiotic medication used to
treat a number of bacterial infections.
Herpes Simplex Virus- a common infection that can cause
painful blisters or ulcers.
Pruritus- is an irritating sensation that makes you want to
scratch.
Tzanck smear- scraping of an ulcer base to look for Tzanck
cell.
Histopathology examination- refers to the microscopic
examination of tissue in order to study the manifestations of
disease.
PCR- the polymerase chain reaction is a methos widely used
to rapidly make millions to billions of copies of a specific
DNA sample, allowing scientists to take a very small sample
of DNA and amplify it to a large enough amount to study in
detail.
Immunofluorescence- is a technique used for light
microscopy with a fluorescence microscope and is used
primarily on biological samples.