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Source: https://www.cdc.gov/std/tg2015/tg-2015-print.pdf

epidemiology

Although the prevalence of chancroid has decreased in the United States and worldwide, sporadic outbreaks can still occur in regions of the Caribbean and Africa. Like other sexually transmitted diseases, having chancroid increases the risk of transmitting and acquiring HIV.

Laboratory findings
From bubo pus or ulcer secretions, H. ducreyi can be identified using special culture media; however, there is a <80% sensitivity. PCR-based identification of organisms is available, but none in the United States that are FDA-cleared. Simple, rapid, sensitive and inexpensive antigen detection methods for H. ducreyi identification are also popular. Serologic detection of H. ducreyi is and uses outer membrane protein and lipooligosaccharide.

Treatment

The CDC recommendation for chancroid is either a single oral dose (1 gram) of azithromycin, a single IM dose (250 mg) of ceftriaxone, oral (500 mg) of erythromycin three times a day for seven days, or oral (500 mg) of Ciprofloxacin twice a day for three days.[6] Data is limited, but there has been reports of ciprofloxacin and erythromycin resistance. Treatment may include more than one prescribed medication.

Aminoglycosides such as Gentamicin, Streptomycin, and Kanamycin have been used to successfully treat Chancroid; however aminoglycoside-resistant strain of H. ducreyi have been observed in both laboratory and clinical settings.[7] Treatment with aminoglycosides should be considered as only a supplement to a primary treatment.

Pregnant and lactating women, or those below 18 years of age regardless of gender, should NOT use Ciprofloxacin as treatment for Chancroid. Treatment failure is possible with HIV co-infection and extended therapy is sometimes required.

Over the last two decades, no new treatment regime for Chancroid or H. ducreyi infection has been published. It is still assumed that the above described treatment regime is and will be effective against H. ducreyi infection.[6]

Follow up

Within 3-7 days after the beginning of treatment, patient should be re-examined to determine if therapy was successful. Within 3 days, symptoms of ulcers should improve. Healing time of the ulcer depends mainly on size and can take more than two weeks for larger ulcers. In uncircumcised men, healing will be slower if the ulcer is under the foreskin. Sometimes, needle aspiration or incision and drainage are necessary.