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Chancroid

Key sources
The following summarized guidelines for the evaluation and management of chancroid are prepared by our editorial team based on guidelines from the Center for Disease Control (CDC 2021) and the International Union Against Sexually Transmitted Infections (IUSTI 2017).
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Guidelines

1.Screening and diagnosis

Diagnostic criteria: as per CDC 2021 guidelines, suspect chancroid in patients with ≥ 1 deep and painful genital ulcers and tender suppurative inguinal adenopathy.
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2.Diagnostic investigations

Screening for other sexually transmitted infections: as per CDC 2021 guidelines, obtain testing for HIV at the time of chancroid diagnosis.
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3.Medical management

Antibiotic therapy: as per CDC 2021 guidelines, administer any of the following regimens in patients with chancroid:
azithromycin 1 g PO in a single dose
ceftriaxone 250 mg IM in a single dose
ciprofloxacin 500 mg PO BID for 3 days
erythromycin base 500 mg PO TID for 7 days.
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  • Management of sexual partners

4.Surgical interventions

Incision and drainage: as per CDC 2021 guidelines, consider performing incision and drainage of buboes instead needle aspiration.
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5.Patient education

General counseling: inform patients that chancroid is a bacterial infection that is sexually transmitted but curable with antibiotics and that it is a cofactor for HIV transmission, as are genital herpes and syphilis.
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6.Follow-up and surveillance

Assessment of treatment response: reassess patients 3-7 days after treatment initiation. Suspect the following if no clinical improvement is evident:
the diagnosis is incorrect
another STI is present
the patient has HIV infection
the treatment was not used as instructed
the Haemophilus ducreyi strain causing the infection is resistant to the prescribed antimicrobial
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