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Chancroid

Chancroid is a bacterial disease that is spread only through sexual contact. Causes: Chancroid is caused by a type of bacteria called Haemophilus ducreyi. The disease is found mainly in developing and third world countries. Uncircumcised men are at much higher risk than circumcised men for getting chancroid from an infected partner. Chancroid is a risk factor for the HIV virus. Symptoms: Within 1 day - 2 weeks after getting chancroid, a person will get a small bump in the genitals. The bump becomes an ulcer within a day of its appearance. The ulcer:

Ranges in size from 1/8 inch to 2 inches across Is painful Is soft Has sharply defined borders Has irregular or ragged borders Has a base that is covered with a grey or yellowish-grey material Has a base that bleeds easily if banged or scraped

About half of infected men have only a single ulcer. Women often have 4 or more ulcers. The ulcers appear in specific locations. Common locations in men are:

Foreskin (prepuce) Groove behind the head of the penis (coronal sulcus) Shaft of the penis Head of the penis (glans) Opening of the penis (urethral meatus) Scrotum

In women the most common location for ulcers is the outer lips of the vagina (labia majora). "Kissing ulcers" may develop. These are ulcers that occur on opposite surfaces of the labia. Other areas such as the inner vagina lips (labia minora), the area between the genitals and the anus (perineal area), and inner thighs may also be involved. The most common symptoms in women are pain with urination and intercourse. The ulcer may look like a chancre, the typical sore of primary syphilis. Approximately half of the people infected with a chancroid will develop enlarged inguinal lymph nodes, the nodes located in the fold between the leg and the lower abdomen.

Half of those who have swelling of the inguinal lymph nodes will progress to a point where the nodes break through the skin, producing draining abscesses. The swollen lymph nodes and abscesses are often referred to as buboes. Exams and Tests: Chancroid is diagnosed by looking at the ulcer(s) and checking for swollen lymph nodes. There are no blood tests for chancroid. Treatment: The infection is treated with antibiotics, including azithromycin, ceftriaxone, ciprofloxacin, and erythromycin. Large lymph node swellings need to be drained, either with a needle or local surgery. Outlook (Prognosis): Chancroid can get better on its own. However, some people may have months of painful ulcers and draining. Antibiotic treatment usually clears up the lesions quickly with very little scarring. Possible Complications: Complications include urethral fistulas and scars on the foreskin of the penis in uncircumcised males. Patients with chancroid should also be checked for syphilis, HIV, and genital herpes. Chancroids in persons with HIV may take much longer to heal. When to Contact a Medical Professional: Call for an appointment with your health care provider if you have symptoms of chancroid. Also call if you have had sexual contact with a person known to have any STD, or if you have engaged in high-risk sexual practices. Prevention: Chancroid is a bacterial infection that is spread by sexual contact with an infected person. Avoiding all forms of sexual activity is the only absolute way to prevent a sexually transmitted disease. However, safe sex behaviors may reduce your risk. The proper use of condoms, either the male or female type, greatly decreases the risk of catching a sexually transmitted disease. You need to wear the condom from the beginning to the end of each sexual activity.

Granuloma inguinale
Granuloma inguinale is a sexually transmitted disease. Causes: Granuloma inguinale is caused by the bacteria Calymmatobacterium granulomatis. The disease spreads mostly through vaginal or anal intercourse. Very rarely, it spreads during oral sex.Men are affected more than twice as often as women, with most infections occurring in people aged 20-40 years. The disease is seldom seen in children or the elderly. Symptoms: Symptoms can occur between 1 to 12 weeks after coming in contact with the bacteria that causes the disease.

About half of infected men and women have lesions in the anal area. Small, beefy-red bumps appear on the genitals or around the anus. The skin gradually wears away, and the bumps turn into raised, beefy-red, velvety nodules called granulation tissue. They are usually painless, but bleed easily if injured. The disease slowly spreads and destroys genital tissue. Tissue damage may spread to the area where the legs meet the torso. This area is called the inguinal folds. Genitals and surrounding skin has a loss of skin color.

In its early stages, it may be difficult to tell the difference between granuloma inguinale and chancroid. In the later stages, granuloma inguinale may look like advanced genital cancers, lymphogranuloma venereum, and anogenital cutaneous amebiasis. Exams and Tests: Granuloma inguinale should be considered if genital lesions have been present for a long time and have been spreading. Tests that may be done include:

Scrapings or punch biopsy of lesion Culture of tissue sample (difficult to do and not routinely available)

Laboratory tests, such as those used to detect syphilis, are available only on a research basis for diagnosing granuloma inguinale. Treatment:

Antibiotics are used to treat granuloma inguinale. A complete cure requires fairly long treatment. Most treatment courses run 3 weeks or until the lesions have completely healed.A follow-up examination is essential because the disease can reappear after an apparently successful cure.

Outlook (Prognosis): Treating this disease early decreases the chances of tissue destruction or scarring. Untreated disease results in destruction of the genital tissue. Possible Complications:

Genital destruction and scarring Loss of skin color in genital area Permanent genital swelling due to scarring

When to Contact a Medical Professional: Call for an appointment with your health care provider if you have had sexual contact with a person who is known to have granuloma inguinale, or if you develop symptoms similar to those listed above. Prevention: Avoiding all sexual activity is the only absolute way to prevent a sexually transmitted disease such as granuloma inguinale. However, safer sex behaviors may reduce your risk. The proper use of condoms, either the male or female type, greatly decreases the risk of catching a sexually transmitted disease. You need to wear the condom from the beginning to the end of each sexual activity.

Lymphogranuloma venereum
Lymphogranuloma venereum (LGV) is a sexually transmitted bacterial infection. Causes Lymphogranuloma venereum (LGV) is a chronic (long-term) infection of the lymphatic system caused by three different types of the bacteria Chlamydia trachomatis. The bacteria spread through sexual contact. The infection is caused by different bacteria than that which causes genital chlamydia. LGV is more common in men than women. The main risk factor is having multiple sexual partners. Symptoms Symptoms of LGV can begin a few days to a month after coming in contact with the bacteria. Symptoms include:

Small painless ulcer on the male genitalia or in the female genital tract Swelling and redness of the skin in the groin area Swollen groin lymph nodes on one or both sides; it may also affect lymph nodes around the rectum in those who have anal intercourse Drainage through the skin from lymph nodes in groin Blood or pus from the rectum (blood in the stools) Painful bowel movements (tenesmus) Swelling of the labia

The infection can cause diarrhea and lower abdominal pain. Women may develop abnormal connections called fistulas between the vagina and rectum. Exams and Tests The health care provider will perform a physical examination and ask questions about your medical history. It is important to tell your doctor if you had sexual contact with someone who has had lymphogranuloma venereum. A physical exam may show:

An ulcer on the genitals An oozing, abnormal connection (fisula) in the rectal area Swollen lymph nodes in the groin (inguinal lymphadenopathy) Drainage through the skin from lymph nodes in the groin Swelling of the vulva or labia in women

Tests may include:

Biopsy of the lymph node

Blood test for the bacteria that causes LGV Laboratory test to detect chlamydia

Treatment This condition can be cured with the proper antibiotics. Those commonly prescribed to treat LGV include tetracycline, doxycycline, and erythromycin. Outlook (Prognosis) With treatment, the outlook is good. Possible Complications

Abnormal connections between the rectum and vagina Brain inflammation (very rare) Infections in the joints, eyes, heart, or liver Long-term inflammation and swelling of the genitalia Scarring and narrowing of the rectum

Complications can occur many years after the initial infection. When to Contact a Medical Professional Call your health care provider if you have been in contact with someone who may a sexually transmitted disease, including LVG. Also call if symptoms of LVG develop. Prevention Abstaining from sexual activity is the only absolute way to prevent a sexually transmitted disease. Safer sex behaviors may reduce the risk. The proper use of condoms, either the male or female type, greatly decreases the risk of catching a sexually transmitted disease. You need to wear the condom from the beginning to the end of each sexual activity.