Haemophilus ducreyi
From IDWiki
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
- Culture for Haemophilus ducreyi from swab of lesion, or PCR if available
- 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
