Chancroid (Soft Chancre)

What is chancroid?

Chancroid (also called soft chancre) is a bacterial infection caused by Haemophilus ducreyi (H. ducreyi). Chancroid is considered a sexually transmitted disease (STD). You might also hear of diseases that are spread through sex called sexually transmitted infections (STIs). Even though chancroid is very contagious, it’s curable.

Is there a difference between syphilis and chancroid?

Syphilis and chancroid are both diseases that are spread through sex, but the germ that causes syphilis isn’t the same as the one that causes chancroid, and treatment is different.

If you have syphilis, you could have a chancre. This is a hard sore or an ulcer that usually forms where the bacteria enters your body, most often in your genital area, but also in your mouth or anus. A chancre usually doesn’t cause pain.

Chancroid is the disease, not the sore. In chancroid, you’ll have a soft chancre (ulcer). These are often painful and red. They don’t have hard edges and they may leak pus.

Who does chancroid affect?

Rates of chancroid in the U.S. and Europe are low, with cases happening only sporadically. It’s more common in developing countries around the world.

One problem with getting actual numbers on chancroid is that it’s difficult to diagnose. It’s often lumped in with other conditions under the term “genital ulcer disease (GUD).”

Anyone who has unprotected sex can get chancroid, but it’s more common in people with uncircumcised penises. Women are often asymptomatic.

What are the signs and symptoms of chancroid?

The incubation period (the time between when you’ve been exposed and when you develop symptoms) for chancroid is about three to seven days. The signs and symptoms of chancroid include:

• Raised and painful bumps on the skin of your genitals.
• Ulcers with ragged soft edges that develop from these bumps.
• Reddened and shiny skin on the sores.
• Leakage of pus and infectious fluid.
• Spreading and connecting of these sores into larger areas.

Women may not be aware of the sores, but they can be painful in men.

What causes chancroid?

Chancroid is a very contagious bacterial disease spread by sexual contact. The bacterium that causes chancroid is called Haemophilus ducreyi (H. ducreyi).

Scientists think that H. ducreyi enters your body through tiny tears in the skin during sexual activity, as it usually doesn’t infect skin that doesn’t have any abrasions.

However, the germ has caused skin ulcers in children and young adults in places like Africa and the South Pacific. The infected fluid (pus) from the ulcer can be transferred to someone without sexual contact.

How is chancroid diagnosed?

It’s somewhat difficult to diagnose chancroid. Scientists can use a test with specialized media to find H. ducreyi, but the media isn’t widely available and the test isn’t 100% accurate. Also, the U.S. Food and Drug Administration (FDA) hasn’t approved any polymerase chain reaction (PCR) tests for chancroid. This type of test finds genetic material from an organism like a virus if you have the virus at the time of the test, or fragments even after you’re no longer infected.

Your healthcare provider will want to rule out syphilis, herpes or lymphogranuloma venereum.

Because of the difficulties with testing, your healthcare provider will diagnose chancroid if:

• You have one or more genital sores (ulcers) that are causing pain.
• You have swollen and painful lymph nodes in your groin.
• You test negative for infection with the herpes simplex virus and Treponema pallidum.

How is chancroid treated?

Your healthcare provider will give you antibiotics to treat chancroid, prescribing one of the following:

• Azithromycin, 1 gram taken orally. This is a one-time dose.
• Ceftriaxone, 250 milligrams (mg) taken as an intramuscular shot. This is a one-time dose.
• Ciprofloxacin, 500 mg taken orally two times per day for three days. You shouldn’t take this if you’re pregnant or breastfeeding.
• Erythromycin, 500 mg taken orally three times per day for seven days.

How long does it take to recover from treatment for chancroid?

You should be feeling better after one to two weeks. Your soft chancres should also start to clear up. If the case was very bad, you might have scars where the ulcers were.

If treatment isn’t successful, your healthcare provider will order additional tests. There’s a chance the diagnosis was wrong or that there’s another viral infection involved.

Another thing to consider is that genital ulcer disease, including chancroid, can make it easier to transmit human immunodeficiency virus (HIV).

Will chancroid clear up on its own?

If you have chancroid and it’s not treated, the sores will probably clear up on their own in one or two months. However, you’re at a higher risk of developing suppurative lymphadenitis, an infection of the soft tissue.

How can I reduce my risk of developing chancroid?

There some things you can do to reduce your risk of developing chancroid, including:

• Abstaining from sex completely.
• Having sex with only one uninfected partner.
• Having safe sex by using condoms for oral, vaginal and anal sex. The condoms must cover any infected area.
• Making sure pus from any infected area doesn’t touch you. If you have a soft chancre, make sure you don’t transfer any pus to another place on your body or to another person.

What is my outlook (prognosis) if I have chancroid?

Chancroid can be treated. If you’re treated, your outlook is good. If you’re not treated, the sores may heal, but you could be more likely to develop a soft tissue infection.

You should be tested for other types of diseases passed through sexual contact, too.

If you develop suppurative lymphadenitis (soft tissue infection), you’re also at risk for the development of fistulas (a type of abnormal tunnel between organs). The tissues of your genitals are at risk of infections that can be destructive, as well.

When should I see my healthcare provider?

If you have any type of sore or pain in your genitals, you should talk to your healthcare provider. If you’re diagnosed with a sexually transmitted disease (STD), you should tell anyone you’ve had sex with, especially those people who might’ve been exposed in the 10 days before you developed symptoms.