Organism Haemophilus ducreyi.

Clinical features An acute venereal infection characterized by a soft chancre on the external genitalia and regional lymphadenop-athy. The lesion has an indurated base of the chancre, which differentiates it from syphilis. Chancroid is a predisposing cause of HIV infection with which it is frequently associated.

Diagnosis The organism can be identified with Gram-stain from the exudate of lesions, but this is often difficult due to secondary infection.

Transmission is by sexual intercourse or direct contact with lesions.

Incubation period 3-14 days.

Period of communicability is as long as lesions continue to discharge, which can be months in the untreated case.

Occurrence and distribution Predominantly found in the tropical regions of the world where it is common in men who probably obtain their infection from a commercial sex worker.

Control and prevention See syphilis above.

Treatment Chancroid can be treated with one of the following regimes:

• azithromycin 1 g orally as a single dose, or

• ceftriaxone 250 mg intramuscularly as a single dose, or

• ciprofloxacin 500 mg orally twice daily for 3 days, or

• erythromycin 500 mg orally four times daily for 7 days.

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