• Also known as soft chancre.
  • Acute, autoinoculable, STI caused by Hemophilus ducreyi.
  • Males affected more commonly.
  • Incubation period: 3-7 days
  • Sites: Frenulum, prepuce, coronal sulcus in male and vulva, vestibule in females.
  • Painful genital ulcers
  • Non-indurated,
  • Bleed on touch
  • Yellow ragged edges
  • Edema of prepuce
  • Tender sometimes suppurative inguinal lymphadenopathy (unilateral in majority).

Secondary infection, ulceration

Hemophilus ducreyi (Pleomorphic gram negative facultative, anaerobic bacillus.)

  • Maintain sexual hygiene
  • Use of protection
  • 10% of patients are co-infected with either HSV or T. pallidum.
  • Males >> females.
  • Occurs in sustained, urban outbreaks.
  • Associated with female commercial sex workers and “sex-for-drugs” trade.

How is it diagnosed?

  • Microscopy
  • Gram stain , Fluorescent labelled monoclonal antibody detection
  • “School of fish” or “rail road track” appearance (gram stain).
  • Serology : ELISA, Immuno dot technique
  • Molecular techniques - PCR
  • Histopathology
  • Growth is best in Mueller Hinton agar supplemented with chocolate horse blood.

How is it treated?

  • Azithromycin 1 gm orally single dose
  • Ceftriaxone 250 mg IM in a single dose
  • Ciprofloxacin 500 mg twice daily x 3 days

Consult with experienced Doctors

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