CHANCROID

Muna Munirah Binti Zamry Norfaizah binti Che Mat Amin

C11110842 C11110859

Advisor dr. Regina Mihardja
Supervisor dr. St. Nur Rahmah, Sp. KK

DEFINITION
• Synonym : Ulcus molle, soft chancre, soft sore • Chancroid is a sexually transmitted, acute ulcerative disease usually localized at the anogenital area and often associated with inguinal adenitis or buboes

and syphillis • Incidence men > women . the use of crack cocaine. America Latin • This endemic regions also have highest rates of human immunodeficiency virus (HIV) infection • Associated with commercial sex worker. Asia.EPIDEMIOLOGY • Endemic in developing countries : Africa.

facultative anaerobic. non motile.ETIOLOGY • Haemophilus ducreyi • Basil gram negative. non spore forming • Requires hemin (X factor) for growth .

PATHOGENESIS Factors in H. ducreyi infection : • Adherence to the epithelial surface • Rate production of exotoxins • Resistence of the host defence mechanism Trauma or microabrasion to the skin or mucosa is necessary for the penetration of the organism into the epidermis. .

and ulcerated • Vesicles are not seen at any stage .CLINICAL MANIFESTATION • • • • Incubation period : 3-7 days No prodromal symptoms Soft papule surrounded erythema After 24-48 hours  pustular. eroded.

sharply demarcated and without induration • Covered by a necrotic yellowish gray exudate • Granulomatous base often bleeds on scraping • Tender.The ulcer : • Ragged undermined edge. not indurated. and painful .

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umbilical. conjunctiva . anal • Women : labium. clitoris. lips. sulcus coronarius. thigh. urethra. glans penis. breast. cervix • Extragenital : tongue. finger.Predilection area • Men : preputium. vestibule. scrotum. fourchette. anal. frenulum. perineum.

• Clinical variant : .Large serpiginous ulcer .Transient chancroid .Phagedenic chancroid .Follicular chancroid .Giant chancroid .Papular chancroid .

• Painful inguinal adenitis (bubo)  unilateral and erythema of the overlying skin • Occurs within few days to 2 weeks after onset of primary lesion .

DIAGNOSIS • • • • Culture Gram/ Giemsa staining. Imunofluoresens technique. Biopsy .

GRAM STAINING Gram-stained smear of exudate from a genital ulcer showing the characteristic chaining pattern of H. .ducreyi.

.GIEMSA STAINING Smear from soft ulcer showing a “school of fish” pattern.

V) Granuloma inguinale .G.DIFFERENTIAL DIAGNOSIS • • • • Herpes genitalis Sifilis stadium I Limfogranuloma venerium (L.

Herpes genitalis .

Sifilis stadium I .

V) .Limfogranuloma venerium (L.G.

Granuloma inguinale .

TREATMENT .

Abscess of inguinal gland. Painful inguinal adenitis. Scarring leading to phimosis. Fistula uretra (rare) . Bacterial superinfection.COMPLICATION • • • • • • Mixed chancre.

genital ulcer and inguinal abscess have been reported to persist for years.PROGNOSIS • This disease is self-limited and systemic spread does not occur. • To avoid reinfections. without treatment. Occaisonally. Local pain is the most frequent complaint. • Antibiotic treatment usually clears up the lesions quickly with very little scarring. . patients must be instructed to use condom properly.

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Immunoassay (IA) Fluorescent trepodermal antibody absorption (FTA-ABS) TREPONERMAL Treponemapallidum particle agglutination (TP-PA) Western blot SYPHILIS TEST Venereal research disease laboratory (VDRL) Rapid plasma reagin (USR) NON.TREPONERMAL Unheated serum reagin (USR) Toludine red unheated serum test (TRUST) .

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