Chancroid is a highly infectious bacterial infection that spreads through sexual contact. It is caused by Haemophilus ducreyi.

It is a tender, elevated bump, or papule, that becomes a pus-filled, open sore with eroded or ragged edges in the groin area. It is soft to the touch (unlike a syphilis chancre that is hard or rubbery).

The bacteria causes painful ulcers or sores in the genital region. Chancroid is a risk factor in the transmission and acquisition of HIV infection. The bacteria are more likely to invade the sexual organs at the point of a pre-existing injury, such as a small cut or scratch.

Different genital ulcers

First signs of infection appear from 3-5 days and up to 2 weeks after contact, and usually, a tender, raised bump develops where the bacteria entered the body:
– inside/outside the vagina or rectum
– occasionally on hands, thighs or mouth
– on the penis

Within 1-4 days, the bump transforms into one or more shallow sores which break open and deepen, becoming:
– filled with pus
– inflamed
– painful
– ruptured

The next stage may persist for several weeks and may result in:

• a painful open sore
• the purulent base of the ulcer
•  several lesions merging to form gigantic ulcers

In over half of the untreated cases, the chancroid bacteria infects the lymph glands in the groin.

The lymph glands in the groin may

• swell, creating a pus-filled bulge, known as a bubo
• enlarge until they burst through the skin
• drain continuously
• remain open
• become infected by other bacteria
• may be firm or fluctuant
• may rupture or ulcerate

What is the difference between a Chancroid and a Chancre?

• The chancre is a lesion typical of infection with the bacterium that causes syphilis, Treponema pallidum. A Chancre is typically painless.
• Chancroid is a lesion typical of disease with the bacterium Haemophilus ducreyi. Chancroid is usually painful.

The typical chancroid bubo:

• appears about 1-2 weeks after the ulcer forms
• is unilateral, spherical, and painful

In men

• 1-4 sores on the penis may develop
• Buboes occur in about 50% of male patients
• The foreskin may swell

The ulcers are usually found in:

• the prepuce near the frenulum
•  coronal sulcus
• glans

Rectal sores may bleed and or cause pain when defecating

In women

• Buboes are uncommon in women
• Dyspareunia (painful sex)
• Dysuria (painful urination)
• Painless sores can develop on the cervix
• Several sores may develop around the vagina and rectum
• Vaginal discharge

The ulcers are usually found on the following:

• Cervix
• The entrance of the vagina, particularly the fourchette
• Labia majora and minora
• Peri-anal area

Rectal sores may bleed and or cause pain when defecating

Main image: Unsplash/ Photo by Pawel Czerwinski on Unsplash