Chancroid... What is it?

Dear Reader, 

It seems you’re ready to sharpen your chancroid (starts with a "sh" sound) knowledge! On to it then: Chancroid is a bacterial infection transmitted through contact with sores on an infected individual’s skin. The bacteria, Haemophilus ducreyi, can lead to painful, open sores and swollen lymph nodes, usually in the groin area. It's relatively rare in the United States (including in infants and children), as it appears to be more prevalent in some regions of Africa and the Caribbean. Additionally, it’s more common in those who were assigned male at birth than those who were assigned female. However, those assigned female at birth can be asymptomatic carriers, meaning they may not experience symptoms but can pass it to others. A proper diagnosis is key to appropriate treatment, as symptoms of chancroid can be confused with genital herpes or primary syphilis. But fear not, for it is treatable (usually with antibiotics), though the sores may clear up on their own! If left untreated, however, chancroid can lead to skin damage. Keep reading for even more detailed information on the condition! 

Chancroid is usually passed via sexual contact, which is why it’s often considered as a sexually transmitted infection (STI). Infected individuals can expect to see the sores appear as tender, red bumps within a few days to two weeks after contact with an infected individual. Then, the bumps develop into painful ulcers that may begin leaking yellow or gray pus and could bleed when scratched. These ulcers are typically one to two centimeters wide with ragged edges. While the ulcers caused by H. ducreyi bacteria are commonly found on or near the genitals, there have been reported cases of this bacteria causing non-genital ulcers in children in some developing countries, such as the South Pacific islands. 

To know for sure if a particular lesion is associated with chancroid, a health care provider typically examines the sores and swollen lymph nodes visually and collects a sample from one of the sores for a laboratory test. However, there may be hurdles in obtaining a definitive diagnosis, as chancroid is rare in the United States and there currently is no Federal Drug Administration (FDA) cleared test. The Centers for Disease Control and Prevention caution that due to the difficulty in obtaining an H. ducreyi culture, chancroid may be under diagnosed in the U.S. For those positively diagnosed, the condition is treated with antibiotics, which usually heal the sores quickly with minimal scarring in about three to seven days. As with any treatment regimen of antibiotics, taking all the medication as prescribed is essential for maximum effectiveness. This is the case even if someone starts to feel better before they have finished. Treatment may also include draining lymph nodes if they’re particularly swollen. Recovery times can vary, depending on the size of the ulcer(s) and the individual. A follow-up appointment to see a health care provider at the end of the treatment period is advised to ensure that the infection has cleared up. In addition to treatment, a health care provider may test for both HIV and syphilis at the time of the initial chancroid test, and then potentially again after three months.  

Folks with a chancroid infection are advised to avoid having vaginal, anal, and oral sex until the treatment is complete, and their ulcers are healed. Furthermore, it’s recommended that any sexual partners that the infected individual has also be evaluated (and if necessary, treated) if they've had sex within ten days prior to the infected individual’s diagnosis. With those recommendations in mind, it’s also good to be aware of what may happen if the condition is left untreated. While chancroid can get better on its own, without proper diagnosis and treatment, there is a chance it can cause damage to the skin and genitals. Additionally, having a chancroid infection has also been associated with an increased risk of contracting (and transmitting) HIV. Folks living with HIV who become infected with chancroid may experience slower healing. 

Early detection is key to reducing symptoms and transmission. When a person knows what their body typically looks and feels like, noticing a change becomes easier. If that change warrants further investigation, it’ll be easier to know when it’s best to see a health care provider to take a closer look. As far as prevention is concerned, using barriers methods (such as external or internal condoms or dams) correctly and consistently may help reduce your risk for infection. However, keep in mind that they won't protect against chancroid if they aren't covering area(s) with an active sore(s). For more information on STIs, getting tested, and safer sex strategies, take a look at the Q&As in the Go Ask Alice! Sexual and Reproductive Health archives.