HAEMOPHILUS

DUCREYI
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.
CLASSIFICATION
 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.
CHARACTERISTIC
 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% CO 2
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
PATHOGENESIS &
PATHOPHYSIOLOGY
 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.
DIAGNOSIS
 Microscopy
 Gramstain
 Immunofluorescence
 EM
 Serologic
 Polyclonal and monoclonal antibodies
 Culture
 Molecular
 DNA probes
 PCR
IMMUNITY
 There is no permanent immunity following
chancroid infection
TREATMENT
 Treatment with intramuscular ceftriaxone,
oral trimethoprim-sulfamethoxazole, or oral
erythromycin often results in healing in 2
weeks.