CHANCROID

DEFINITION

Chancroid is a sexually-transmitted disease

characterized by painful genital ulcers and inguinal
adenitis.
It is characterized by painful necrotizing genital
ulcers that may be accompanied by inguinal
lymphadenopathy.
It is highly contagious but curable disease
It is a subclass of sexually transmit
 INFECTIOUS AGENT

Haemophilus discreyi, a gram negative, non-spore-forming

stretobacillus
 INCUBATION PERIOD

One to fourteen days, with an average of

three to five days
 HOW TO GET CHANCROID?

Sexual transmission through skin to skin

contact with open sore
Non-sexual transmission when pus-like fluid
from ulcer is moved to other parts of the
body or to another person.
A person is considered to be infectious
when ulcers are present.
 PATHOLOGY

Lesions are usually confined to the genital

sites most commonly traumatized during
sexual contact.
A lesion begins as a small papule
surrounded by a zone of erythema and
soon erodes to produce a sharply-
circumscribed, non-endurated ulcer with a
granulating base.
Multiple lesions may develop rapidly by
autoinoculation and suppurative adenitis.
 PATHOLOGY

In women, labia majora is the most common location for

ulcers.
Ulcers that occur on opposing surfaces of the labia is called
kissing ulcers
Other areas such as the labia minora, perineal area and inner
thigh may also be involved.
Most common symptoms in woman are pain during urination
and intercourse.
1/3 of infected individuals can develop enlargements of the
inguinal lymph nodes.
Half of those who develop swelling of the inguinal lymph
nodes progress to a point where the nodes rupture through
the skin, producing draining abscesses which is called
buboes.
BUBOES
 COMPLICATION

The lymph node glands in the groin become

infected within 5 8 days of appearance of initial
sores.
Glands on one side become enlarged, hard, painful
and fuse together to form a bubo, an inflammation
and swelling of one or more lymph nodes with
overlying red skin.
Ruptured buboes are susceptible to secondary
bacterial infection
LESION
 SIGNS AND SYMPTOMS

Small lesions appear at the groin for inner thigh.

For male it can appear on the penis
For female it can appear on the vulva, vagina and cervix
These lesions may appear on the lips, tongue, breasts or
navel.
The papule rapidly ulcerates which can become painful, soft
and malodorous. This bleeds easily and produce pus.
Within 2-3 weeks, inguinal adenitis may develop, creating
suppurated, inflamed nodes that may rupture into large
ulcers or buboes.
During the healing stage, phimosis may develop
 SIGNS AND SYMPTOMS

Small lesions appear at the groin for inner thigh.

For male it can appear on the penis
For female it can appear on the vulva, vagina and cervix
These lesions may appear on the lips, tongue, breasts or
navel.
The papule rapidly ulcerates which can become painful, soft
and malodorous. This bleeds easily and produce pus.
Within 2-3 weeks, inguinal adenitis may develop, creating
suppurated, inflamed nodes that may rupture into large
ulcers or buboes.
During the healing stage, phimosis may develop
 SIGNS AND SYMPTOMS

Men may notice a small, red bump on genitals that

may change to an open sore within a day or two
Women may develop four or more red bumps on
the labia, between the labia and anus or on the
thighs.
The ulcers have a soft center thats gray to
yellowish gray with defined, or sharp, edges.
Ulcers may bleed easily if touched
Pain may occur during sexual intercourse while
urinating
 DIAGNOSIS

Blood agar culture provides a reliable diagnosis 75% of

the time

Gram stains of ulcer exudate or bubo aspirate are 50%

reliable

Biopsy- confirms the diagnosis but is used only in resistant

case or when cancer is suspected

Dark-field examination using a microscope

Serologic testing blood tests that look for antibodies in

your blood
 TREATMENT

Azithromycin 500 mg, taken orally as a single dose

Erythromycin 500 mg, 1 cap BID x 7 days

Ceftriaxone 250mg IM as a single dose

Ciprofloxacin 500 mg orally

Surgical drainage of the bubo may be necessary to

relieve pain
 NURSING MANAGEMENT

Standard precaution should be practiced.

Administer anti-infective medications and, and possible,

analgesics as ordered.

Check for drug allergy

Provide topical care by washing the affected area with soap

and water followed by bactericidal agent.

Examine the patients sexual contacts, and refer them for

treatment, even if theyre asymptomatic.

 NURSING MANAGEMENT

Monitoring
Monitor the effectiveness of analgesic by asking the client to rate his
pain before and after receiving the drug.
Inspect the ulcers for sign of healing as well as signs of localized
infection
Patient teaching
Instruct the patient to make his anti-infective medication for the
period prescribed.
Teach patient not to apply creams, lotions or oils on or near his
genitalia or on other lesion site.
Advise the patient to abstain from sexual contact until follow-up
evaluation shows that healing is complete.
Counsel the patient about HIV infection
Inform the patient that condoms may provide protection from future
infection
 NURSING DIAGNOSIS

Ineffective sexuality patterns related to need for abstinence

during therapy

Impaired skin integrity related to genital or inguinal ulcers

caused by chancroid

Acute pain related to ulcers caused by chancroid

 PREVENTION

Teach client to avoid sexual activity with infected

persons.
Use protection, such as condom, during sexual
activity
Wash the genitalia with soap and water after
sexual activity
Alert all partners if you develop the condition so
that they may be tested and treated as well
Mutual monogamy