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.
 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.
 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% CO2 at 33C.
Transport medium using Stuarts, 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
 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.
 Microscopy
Gramstain
Immunofluorescence
EM
Serologic
Polyclonal and monoclonal antibodies
Culture
Molecular
DNA probes
PCR
 There is no permanent immunity following
chancroid infection
 Treatment with intramuscular ceftriaxone,
oral trimethoprim-sulfamethoxazole, or oral
erythromycin often results in healing in 2
weeks.