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dr.R.Varidianto Yudo T.

,MKes
Laboratorium Mikrobiologi
Fakultas Kedokteran Universitas Hang Tuah
 Haemophilus ducreyi causes chancroid (soft
chancre), a sexually transmitted disease.
 Chancroid consists of a ragged ulcer on the
genitalia, with marked swelling and
tenderness.
 The regional lymph nodes are enlarged and
painful.
 The disease must be differentiated from
syphilis, herpes simplex infection, and
lymphogranuloma venereum.
 H. ducreyi was originally placed in the genus
Haemophilus because of its requirement for
hemin (X-factor) and a G+C content that was
within the accepted range for Haemophilus
spp
 Some author classify H. ducreyi in the family
Pasteurellaceae  Sequencing of the 16S
rRNA of the type strain CIP542 and two
additional strains confirmed that H. ducreyi
was a member of the Pasteurellaceae.
 The small gram-negative rods occur in strands in
the lesions, usually in association with other
pyogenic microorganisms.
 H.ducreyi requires X factor (hemin) but not V
factor (NAD/NADP).
 It is grown best from scrapings of the ulcer base
on chocolate agar containing 1% IsoVitaleX
(Cysteine) and vancomycin, 3 g/mL, and
incubated in 10% CO2 at 33°C.
 Transport medium using Stuart’s, Amies’, and
four newly formulated thioglycolate-hemin-
based transport media containing various
combinations of selenium dioxide, albumin, and
glutamine.
 Potential virulence factors
 Pili
 Lipopolysaccharide
 Iron-Regulated Proteins
 Cytotoxins and Hemolysins
 Heat Shock Proteins
 Outer Membrane Proteins
 The portal of entry of H. ducreyi is a break in
the integrity of the epithelium.
 It is around this break in the epithelium that the
first pathological changes, in the form of
edematous and swollen epithelial cells with an
infiltration of polymorphonuclear leukocytes, are
observed.
 Externally, this is seen as a small inflammatory
papule surrounded by a narrow erythematous
zone. Within 2 or 3 days a pustule forms that
soon ruptures, resulting in a sharply
circumscribed ulcer with ragged undermined
edges and without induration.
 The base of the ulcer, in contrast to the smooth
base of a syphilitic chancre, is irregular with
many projections and depressions, giving it a
granular appearance.
 The crater may be partially filled with what has
been described as a gray or yellow necrotic
purulent exudate
 Chancroid ulcers are very vascular, and the
friable granulomatous base of the ulcer bleeds
easily on scraping.
 There is little inflammation of the surrounding
skin.
 The ulcers are always painful and, depending on
their site, some are more painful than others.
 Microscopy
 Gram stain
 Immunofluorescence
 EM
 Serologic
 Polyclonal and monoclonal antibodies
 Culture
 Molecular
 DNA probes
 PCR
 Thereis no permanent immunity following
chancroid infection
 Treatment with intramuscular ceftriaxone,
oral trimethoprim-sulfamethoxazole, or oral
erythromycin often results in healing in 2
weeks.