Among venereal diseases, chancre ranks third after syphilis and gonorrhea, which is why it is also called the third venereal disease (synonymous with chancroid). On the territory of the former USSR, this infection is rare and, as a rule, is diagnosed in people who traveled abroad. The infection is common among the population of the tropics and subtropics (Africa, Southeast Asia, South America). In a number of regions, infection with chancroid exceeds infection with syphilis. According to statistics, syphilis and / or genital herpes are diagnosed in 10% of patients with chancroid. Read about the pathogen, symptoms, diagnosis and treatment of the disease at estet-portal.com.
Pathogen and routes of infection of soft chancre
The disease is caused by the gram-negative bacillus Haemophilus ducreyi (Ducrey's streptobacillus). The bacterium is resistant to chemicals, tolerates low temperatures well, but dies at 40 degrees and above.
The causative agents of chancre have an ampicillin-resistant plasmid, due to which bacteria have a natural resistance to antibiotics of the penicillin and streptomycin series.
The disease is transmitted only sexually. The exception is medical staff. laboratories that become infected with chancroid when the instructions for working with infectious material are not followed (neglect of gloves).
The entrance gates for infection are damaged skin and mucous membranes. It is possible to become infected with a soft chancre through any sexual contact (oral, vaginal or anal sex).
Transplacental transmission of the infection is not possible, as evidenced by the absence of signs of illness in children born to women with active symptoms of chancre.
Characteristic clinical manifestations of chancre
The period from the moment of infection to the appearance of clinical manifestations of the disease lasts an average of 3 – 10 days. In some cases (weakened immunity) the incubation period is shortened to 24 – 48 hours. In women, chancroid appears later, the incubation period may be extended to several weeks, which is associated with the individual characteristics of the infected.
Prodromal phenomena with soft chancre are often absent. A papule (a bright, red papule that rises above the skin) appears at the site of the introduction of the bacterium. In the center of the papule, a dense nodule is formed, the contents of which are pus. A few days later, the nodule opens, and an ulcer forms in its place, the size of which ranges from a few millimeters to 1.5–4 centimeters. The edges of the ulcer, which is a soft chancre, are uneven and surrounded by an inflammatory shaft. The bottom of the ulcer is covered with a purulent-bloody coating. The size of the ulcerative wound increases rapidly, the wound itself deepens and bleeds. If the purulent discharge falls on nearby tissues, new small sores appear, which later merge with the main one. The formation of a large ulcer is called creeping.
Differences between soft chancre and syphilitic chancre:
• soreness;
• bleeding;
• soft consistency;
• presence of an inflammatory shaft;
• multiple ulcerations.
The stage of ulcerative formations takes 2 – 4 weeks, after which there is a cleansing of the ulcerative bottom and scarring (provided there is no secondary infection and the development of complications). Complete healing of ulcers is observed after 1 – 2 months after infection.
In the absence of adequate treatment, regional lymph nodes are involved in the infectious process, which leads to the formation of purulent lymphadenitis.
Where can a soft chancre be located
In men, ulcers are localized on the outer or inner surface of the foreskin, in the coronal sulcus, on the head and shaft of the penis. Typical localization of ulcers in women: large and small labia, clitoral region, vaginal vestibule, pubic region, cervix. If anogenital and orogenital sexual contacts have taken place, ulcers are found around the anus (in the form of an anal fissure), on the mucous membrane of the mouth, pharynx and lips.
In medical workers, chancres are found on the skin of the hands in places of abrasions, scratches. In persons who neglect hygiene, secondary ulcers form on the gluteal region and inner thighs.
Therapeutic measures for chancre
Treatment of the disease is carried out in two directions: systemic therapy and local treatment of ulcers. Systemic therapy includes the appointment of antibiotics and sulfonamides. Since the bacterium is resistant to penicillin, preference is given to broad-spectrum antibiotics: fluoroquinolones, cephalosporins, macrolides. If a mixed infection (combination with pale treponema) is suspected, antibiotics are prescribed that do not have activity against the causative agent of syphilis – aminoglycosides.
Local treatment consists in the treatment of the skin around the ulcers with antiseptic solutions and the treatment of ulcers with sulfonamide ointments. To stimulate the immune system, multivitamin complexes and immunomodulators are prescribed.
Timely and adequate treatment of the disease helps to avoid the following complications: phimosis, paraphimosis, gangrenization, lymphadenitis. After recovery, all patients are taken for clinical and serological control for syphilis (6 months).
See also: Typical and atypical signs of syphilis: how to recognize the disease in time
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