Chancroid (Haemophilus Ducreyi)

Chancroid usually causes one or more painful sores or ulcers on the genitals that develop 3–10 days after exposure, although symptoms can appear sooner or later in some cases.

Common symptoms include:

• Painful, soft genital ulcers with ragged edges and a grey or yellow base
• Sores that may bleed easily if touched
• Swollen and tender lymph nodes in the groin, which may occasionally form abscesses and drain pus
• Pain during urination or bowel movements, depending on the location of the ulcers

Because its symptoms can resemble those of other sexually transmitted infections, such as genital herpes or syphilis, any new genital sores or painful lumps should be assessed by a healthcare professional.

Yes. Although chancroid usually causes painful genital ulcers, some people have no noticeable symptoms. This appears to be more common in women, where ulcers may occur in areas that are difficult to see.

Even without symptoms, the infection can still be passed on through sexual contact.

If you think you may have been exposed to Haemophilus ducreyi or have had sexual contact with someone diagnosed with chancroid, a clinical assessment and appropriate testing are recommended.

Without treatment, chancroid can cause painful complications and increase the risk of acquiring or transmitting other sexually transmitted infections.

Possible complications include:

• Large, painful swollen lymph nodes (buboes) that may rupture and drain pus
• Larger or deeper genital ulcers that may leave permanent scarring
• Secondary bacterial infection of the ulcers
• Tightening of the foreskin (phimosis) in uncircumcised men due to inflammation
• An increased risk of acquiring or transmitting HIV because of open genital ulcers

Early diagnosis and antibiotic treatment help prevent most complications.

Symptoms of chancroid usually develop 3–10 days after exposure to Haemophilus ducreyi, although they may appear as early as 1 day or as late as 2 weeks.

The first sign is typically a small, tender red bump on the genitals that quickly develops into a painful ulcer. Swollen and tender lymph nodes in the groin may also occur.

Because similar symptoms can be caused by other conditions, prompt assessment and testing for other STIs, particularly genital herpes, syphilis and HIV, are recommended to confirm the diagnosis and guide appropriate treatment.

Chancroid is caused by the bacterium Haemophilus ducreyi.

It spreads through direct skin-to-skin contact during vaginal, anal, or oral sex. The bacteria enter the body through tiny breaks in the skin or mucous membranes, leading to painful genital ulcers and, in some cases, swollen lymph nodes in the groin.

Although chancroid is rare in the UK, it remains more common in some parts of Africa, Asia, and the Caribbean. Prompt diagnosis and antibiotic treatment can effectively clear the infection.

The main risk factor for chancroid is having sexual contact with someone infected with Haemophilus ducreyi.

Other factors that increase the risk include:

• Having vaginal, anal, or oral sex without a condom
• Having multiple sexual partners
• Travelling to, or having sexual contact in, regions where chancroid is more common, such as parts of Africa, Asia, and the Caribbean
• Having other sexually transmitted infections or small cuts or abrasions that make it easier for the bacteria to enter the skin

Although condoms significantly reduce the risk, they do not provide complete protection because infected areas may not be fully covered.

If you develop painful genital ulcers or swollen groin glands, seek a sexual health assessment.

Using condoms consistently and correctly is one of the best ways to reduce the risk of chancroid, although they cannot provide complete protection.

You can also lower your risk by:

• Using condoms or dental dams during vaginal, anal, and oral sex
• Avoiding sexual contact with anyone who has genital sores or ulcers
• Avoiding sex if you develop unexplained genital symptoms until you have been assessed
• Having regular sexual health check-ups if you have new or multiple partners
• Taking extra precautions if travelling to regions where chancroid is more common

Yes. Condoms significantly reduce the risk of chancroid but do not eliminate it.

The infection spreads through direct contact with infected sores. If a sore is located on skin that is not covered by a condom, such as the base of the penis, scrotum, vulva, or surrounding genital area, transmission can still occur.

If you develop painful genital ulcers or think you may have been exposed, arrange a sexual health assessment.

It is very unlikely.

Chancroid is almost always spread through direct contact with infected sores during vaginal, anal, or oral sex. Transmission through kissing would only be possible if an active sore were present on the mouth or lips, which is extremely rare.

If you have painful genital ulcers or sores, seek medical assessment for an accurate diagnosis.

No. Chancroid is not spread through sharing towels, bedding, clothing, toilet seats, or other personal items.

Haemophilus ducreyi does not survive well outside the body and is transmitted almost exclusively through direct contact with infected sores during sexual activity.

No. Chancroid is not transmitted through blood transfusions.

Haemophilus ducreyi causes a local infection of the skin and mucous membranes and is not known to spread through donated blood. It is transmitted primarily through direct contact with infected sores during sexual activity.

Chancroid is diagnosed using a combination of a physical examination and laboratory testing.

A healthcare professional will examine any genital ulcers and may take a swab from the ulcer or fluid from a swollen lymph node for laboratory testing. Where available, PCR testing may be used to detect Haemophilus ducreyi, the bacterium that causes chancroid. Because the infection is rare in the UK, tests for other causes of genital ulcers, particularly genital herpes and syphilis, are usually performed at the same time.

A swab from a genital ulcer is the most commonly collected sample for laboratory testing. Where available, PCR (polymerase chain reaction) testing can detect the genetic material of Haemophilus ducreyi.

Depending on your symptoms, other tests may include:

• Swabs for herpes simplex virus (HSV)
• Blood tests for syphilis
• HIV testing, where appropriate
• A sample from a swollen lymph node if significant swelling is present

Testing for multiple sexually transmitted infections helps ensure an accurate diagnosis and appropriate treatment.

A correct diagnosis is based on your symptoms, medical history, examination findings, and laboratory test results.

Important factors include:

• Painful genital ulcers
• Swollen and tender lymph nodes in the groin
• Recent travel to, or sexual contact in, regions where chancroid is more common
• Laboratory findings consistent with Haemophilus ducreyi, where testing is available
• Tests that rule out other causes of genital ulcers, such as genital herpes and syphilis

Considering all of these factors helps distinguish chancroid from other causes of genital ulcers.

Yes. Several conditions can cause similar symptoms and may be mistaken for chancroid.

These include:

• Genital herpes
• Syphilis
• Lymphogranuloma venereum (LGV)
• Granuloma inguinale (donovanosis)
• Behçet's disease
• Other inflammatory skin conditions that can cause genital ulcers

Because the treatments differ, clinical assessment and appropriate laboratory testing are essential for an accurate diagnosis.

Laboratory testing is the preferred method, but diagnosis also relies on a clinical assessment and excluding other conditions.

Where available, PCR testing on a swab from a genital ulcer is the preferred laboratory test. In some cases, bacterial culture or Gram stain may be attempted, although Haemophilus ducreyi is difficult to grow and these methods are generally less sensitive.

If laboratory testing is unavailable or inconclusive, a healthcare professional may consider your symptoms, examination findings, and travel history when deciding on treatment.

No. A physical examination can suggest chancroid, but it cannot confirm the diagnosis.

Many conditions can cause similar genital ulcers, including genital herpes and syphilis. Laboratory testing is usually needed to identify the underlying cause and ensure you receive the correct treatment.

No. Chancroid cannot be reliably diagnosed at home.

Painful genital ulcers can be caused by several different conditions, including genital herpes and syphilis, which require different treatments. If you notice any new genital ulcers, sores, or swollen groin lymph nodes, you should arrange a sexual health assessment for examination and appropriate testing.

The long-term outlook for chancroid is excellent when it is diagnosed and treated promptly with antibiotics.

Most people make a full recovery without lasting health problems. Symptoms often begin to improve within a few days of starting treatment, and genital ulcers usually heal within 1 to 2 weeks. Larger ulcers may leave some scarring.

Without treatment, chancroid can persist and lead to complications such as painful groin abscesses (buboes), scarring, and an increased risk of acquiring or transmitting HIV because of open genital ulcers.

Once the infection has cleared, there are no known long-term effects on general health or fertility.

No. Having chancroid does not provide immunity.

Although antibiotics cure the current infection caused by Haemophilus ducreyi, you can become infected again if you are exposed in the future.

To reduce the risk of reinfection:

• Complete your full course of antibiotics.
• Avoid sexual contact until treatment is complete and all genital ulcers have fully healed.
• Ensure recent sexual partner(s) are assessed and treated where appropriate.
• Use condoms consistently during vaginal, anal, and oral sex, recognising that they cannot fully protect skin not covered by the condom.

Chancroid does not usually recur once it has been successfully treated. Prevention focuses on avoiding reinfection.

You can reduce your risk by:

• Completing your full course of antibiotics.
• Avoiding sexual contact until treatment is complete and all genital ulcers have healed.
• Ensuring recent sexual partner(s) are assessed and treated where appropriate.
• Using condoms consistently during vaginal, anal, and oral sex.
• Attending regular sexual health check-ups if you have new or multiple sexual partners or develop new symptoms.

Yes. If you have been diagnosed with chancroid, it is important to inform any recent sexual partner(s) so they can be assessed and treated if necessary.

A person with chancroid may pass the infection on before they realise they are infected or even if their symptoms are mild. Partner notification helps prevent reinfection and reduces onward transmission.

If you do not feel comfortable informing your partner(s) yourself, your sexual health clinic may be able to offer confidential partner notification.

Avoid sexual contact until both you and your partner(s) have completed treatment and any genital ulcers have fully healed.

Yes. The best way to prevent passing chancroid to others is to avoid all sexual contact until you have completed treatment and all genital ulcers have fully healed.

You should also:

• Complete your full course of antibiotics.
• Inform recent sexual partner(s) so they can be assessed and treated where appropriate.
• Use condoms consistently during future vaginal, anal, and oral sex, recognising that they may not protect skin that is not covered.
• Wash your hands thoroughly after touching affected areas to reduce the risk of spreading bacteria to other parts of your body.

Following these steps helps protect both you and your sexual partner(s).

Current evidence suggests that chancroid is not transmitted to the baby during pregnancy through the placenta.

If active genital ulcers caused by Haemophilus ducreyi are present during vaginal birth, there is a very small risk the baby could be exposed to the bacteria during delivery, although this appears to be extremely uncommon.

Any genital ulcers during pregnancy should be assessed promptly, as other infections with similar symptoms, such as genital herpes or syphilis, can affect the baby and require different management.

If chancroid is diagnosed, it can usually be treated safely with appropriate antibiotics during pregnancy.

here is no strong evidence that chancroid causes birth defects or directly affects the baby's development. However, prompt diagnosis and treatment are important to protect the health of the pregnant person.

Possible complications include:

• Painful genital ulcers
• Swollen or infected lymph nodes that may require treatment
• An increased risk of acquiring or transmitting other sexually transmitted infections, including HIV

If you develop genital ulcers during pregnancy, prompt assessment is recommended to confirm the cause and begin appropriate treatment.

Chancroid is very rare in the UK, including during pregnancy.

Most cases occur following travel to, or sexual contact in, regions where the infection is more common, such as parts of Africa, Asia, and the Caribbean. It is not routinely screened for during pregnancy.

If you develop genital ulcers, sores, or swollen groin lymph nodes while pregnant, seek medical assessment promptly, regardless of the suspected cause.

Yes. Chancroid can usually be treated during pregnancy with antibiotics that are considered safe for both the pregnant person and the baby.

Treatment may include:

• Azithromycin (single oral dose)
• Ceftriaxone (single injection)
• Erythromycin (7-day course)

Your clinician will prescribe the most appropriate antibiotic based on current treatment guidelines and your individual circumstances.

Prompt treatment helps clear the infection, relieve symptoms, and reduce the risk of complications.

The best way to reduce the risk of chancroid during pregnancy is to practise safer sex and seek early assessment for any symptoms.

This includes:

• Using condoms during vaginal, anal, and oral sex
• Avoiding sexual contact with anyone who has genital ulcers or sores
• Seeking medical advice promptly if you develop genital symptoms or think you may have been exposed
• Informing your healthcare provider about recent travel to regions where chancroid is more common
• Ensuring recent sexual partner(s) are assessed and treated where appropriate if an infection is diagnosed

Early diagnosis and treatment help protect your health and reduce the risk of reinfection.

Yes. Chancroid may make postpartum recovery more uncomfortable if genital ulcers are present after childbirth.

However, Haemophilus ducreyi is not known to be transmitted through breast milk. If treatment is needed while breastfeeding, your clinician will prescribe an antibiotic that is appropriate for your individual circumstances.

If you develop genital ulcers or any unusual symptoms after giving birth, seek medical advice promptly for assessment and treatment.