A 51 years old Male Diagnosed with Chancroid by Simple Examination

Abstract

Chancroid is infection caused by Haemophylus ducreyi. Diagnosis depends on the identification of H. Ducreyi through laboratory cultures. The difficulties of diagnosis causing by rarity of its presentation.  This case shows the diagnosis of chancroid with a simple examination. A 51 year old man with painful ulcer in penile shaft. He had unprotected sexual activity with sexual workers. The lesion shows 2-3 mm ulcer with purulent discharge. Gram stain showed gram negative in chains formations. VDRL, TPHA and HIV test were negative. We were given Azithromycin 1 gram single dose, mefenamic acid 500 mg thrice a day and compress normal saline twice per day. Patient had recovery after 3 days. Chancroid is painful ulcer and bacteria enters during sexual intercourse. Laboratory examination like culture of organism and PCR assay are costly and not commonly available. Microscopy examination is simple test and show railroad track. The presumptive criteria for chancroid are one or more painful genital with chancroid typical lesion, Treponema pallidum and herpes test are negative. In this case, patient has a painful ulcer with purulent discharge, history unprotected sexual activity with sexual worker, VDRL/TPHA test is negative, Gram-stain show coccobacillus in rail road track and have recovery in 3 days after azithromycin treatment. Simple examination can help doctor to diagnose chancroid especially who work with limited facilities. We can treat as a chancoid when the presumptive is established.