Saturday, January 01, 2011
The diagnosis of chancroid is usually clinical, although
improved culture techniques allow isolation of the causative
organism H. ducreyi. The therapeutic strategy is to
eliminate the pathogenic microorganism.
Azithromycin 1 g orally as a single dose.
- Ceftriaxone 250 mg intramuscular in a single dose.
- Ciprofloxacin 500 mg twice daily for 3 days.
- Erythromycin 500 mg three times daily for 7 days.
- Successfully treated ulcers will show symptomatic improvement
by 3 days and evidence of healing by 7 days. If the patient fails
to improve and the diagnosis is correct, consider coexistent HIV
infection, antibiotic resistance, a second coexistent sexually
transmitted infection, and noncompliance.
- Inguinal nodes (buboes) may continue to progress despite
adequate treatment. Aspirate fluctuant nodes with a large-bore
- Evaluate all patients for other sexually transmitted
- Sexual contacts of infected persons must be traced and
- The antimicrobial sensitivity of H. ducreyi is
regionally variable and evolving. Direct therapy by known
antibiotic sensitivity patterns in the community of
- Look for simultaneous infection by herpes simplex and/or
- Gram stain for diagnosis is not always reliable.