Haemophilus ducreyi: Difference between revisions

Latest revision as of 16:16, 3 December 2020

Background

Causes chancroid

Microbiology

Fastidious Gram-negative bacillus

Epidemiology

Present worldwide
Endemic when sex workers, for example, are pressured to have sex with multiple partners despite active genital lesions

Clinical Manifestations

Presents initially with a papule at the site of inoculation, progressing to pustules, which rupture into painful, purulent, and shallow ulcers
- Ulcer base often bleeds
- In men, lesions are more common on the prepuce, coronal sulcus, or penile shaft
- In women, lesions occur more commonly on external genitalia, but can also occur within the vagina or on the cervix
Often multiple ulcers
May have associated painful lymphadenitis, which can drain

Diagnosis

Not culturable
PCR if available
Most commonly diagnosed with tissue biopsy using Giemsa or Wright stains
Rule out other causes as appropriate with NAAT or PCR

Management

First-line: ciprofloxacin 500 mg PO once
Alternatives: erythromycin 500 mg PO tid for 7 days, azithromycin 1 g PO once, or ceftriaxone 250 mg IM once
Rule out other STIs

@@ Line 1: / Line 1: @@
-== Background ==
+==Background==
-* Causes '''chancroid'''
+*Causes '''chancroid'''
-=== Microbiology ===
+===Microbiology===
-* Fastidious Gram-negative bacillus
+*Fastidious Gram-negative bacillus
-=== Epidemiology ===
+===Epidemiology===
-* Present worldwide
+*Present worldwide
-* Endemic when sex workers, for example, are pressured to have sex with multiple partners despite active genital lesions
+*Endemic when sex workers, for example, are pressured to have sex with multiple partners despite active genital lesions
-== Clinical Manifestations ==
+==Clinical Manifestations==
-* Presents initially with a papule at the site of inoculation, progressing to pustules, which rupture into painful, purulent, and shallow ulcers
+*Presents initially with a papule at the site of inoculation, progressing to pustules, which rupture into painful, purulent, and shallow ulcers
-** Ulcer base often bleeds
+**Ulcer base often bleeds
-** In men, lesions are more common on the prepuce, coronal sulcus, or penile shaft
+**In men, lesions are more common on the prepuce, coronal sulcus, or penile shaft
-** In women, lesions occur more commonly on external genitalia, but can also occur within the vagina or on the cervix
+**In women, lesions occur more commonly on external genitalia, but can also occur within the vagina or on the cervix
-* Often multiple ulcers
+*Often multiple ulcers
-* May have associated painful [[lymphadenitis]], which can drain
+*May have associated painful [[lymphadenitis]], which can drain
-== Diagnosis ==
+==Diagnosis==
+*Not culturable
-* Culture for ''Haemophilus ducreyi'' from swab of lesion, or PCR if available
+*PCR if available
-* Rule out other causes as appropriate with NAAT or PCR
+*Most commonly diagnosed with tissue biopsy using Giemsa or Wright stains
+*Rule out other causes as appropriate with NAAT or PCR
-== Management ==
+==Management==
-* First-line: [[Is treated by::Ciprofloxacin]] 500 mg PO once
+*First-line: [[Is treated by::ciprofloxacin]] 500 mg PO once
-* Alternatives: [[Is treated by::erythromycin]] 500 mg PO tid for 7 days, [[Is treated by::azithromycin]] 1 g PO once, or [[Is treated by::ceftriaxone]] 250 mg IM once
+*Alternatives: [[Is treated by::erythromycin]] 500 mg PO tid for 7 days, [[Is treated by::azithromycin]] 1 g PO once, or [[Is treated by::ceftriaxone]] 250 mg IM once
-* Rule out other STIs
+*Rule out other STIs
 {{DISPLAYTITLE:''Haemophilus ducreyi''}}