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Chancroid diagnosis and treatment

Last updated: March 2014

Background

  • chancroid is caused by Haemophilus ducreyi
  • it is rarely diagnosed in Australia but is a more common cause of genital ulceration in Africa and Asia
  • clinical features include ano-genital ulceration and lymphadenitis with progression to bubo formation.

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Diagnosis

Presumptive

Clinical suspicion especially in patients with a sexual history suggestive of exposure and presenting with ano-genital ulceration and lymphadenitis

Confirmed

Positive NAAT (nucleic acid amplification test, such as PCR) of lesion swab

  • Specialised laboratory outside of South Australia sent via SA Pathology

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Management

Standard treatment

Azithromycin 1 gram as one dose

or

Ceftriaxone 500mg IMI as one dose

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Patient education

The following points should be discussed

  • the importance of immediate testing and treating of all sex partners
  • abstinence from sex until treatment completed
  • need for follow up clinical review in 1 week
  • need for follow up testing for cure 6 weeks after completion of treatment
  • patient education/provision of literature on Chancroid
  • that Chancroid is a notifiable disease.

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Contact tracing

Patients need to be contact traced/referred for contact tracing

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Follow up

  • Evaluation of symptoms and signs until resolved
  • check reaction to medication
  • enquiry about sexual activity since treatment
  • ensure contact tracing has occurred
  • screen for other STIs (if not done already) and arrange follow up at 3 months for blood borne virus serology and syphilis testing
  • need for follow up testing for cure 6 weeks after completion of treatment
  • advise condom use until serology at 3 months in case of concomitant undiagnosed HIV, syphilis or hepatitis.

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Further information

For further information on the diagnosis and management of genital chlamydia trachomatis contact Clinic 275.

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Disclaimer

These guidelines are based on review of current literature, current recommendations of the United States Centers for Disease Control and Prevention, World Health Organization, the British Association for Sexual Health and HIV and local expert opinion.

They are written primarily for use by Clinic 275 staff and some flexibility is required in applying them to certain private practice situations.

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