Umbrella

Chancroid is a sexually transmitted infection characterized by painful sores on the genitalia. Chancroid is known to be spread from one to another individual through sexual contact.

Causes Chancroid is a bacterial infection caused by the fastidious Gram-negative streptobacillus Haemophilus ducreyi. It is a disease found primarily in developing countries, associated with commercial sex workers and their clientele. Infection levels are low in the western world, typically around one case per two million of the population (Canada, France, UK and USA). Most individuals diagnosed with chancroid have visited countries or areas where the disease is known to occur frequently, although outbreaks have been observed in association with crack cocaine use and prostitution. Uncircumcised men are at three times greater risk than circumcised men for contracting chancroid from an infected partner. Chancroid is a risk factor for contracting HIV, due to their ecological association or shared risk of exposure, and biologically facilitated transmission of one infection by the other. Symptoms and signs After an incubation period of one day to two weeks, chancroid begins with a small bump that becomes an ulcer within a day of its appearance. The ulcer characteristically:

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Ranges in size dramatically from 3 to 50 mm (1/8 inch to two inches) across Is painful Has sharply defined, undermined borders Has irregular or ragged borders Has a base that is covered with a gray or yellowish-gray material Has a base that bleeds easily if traumatized or scraped

More specifically, the CDC's standard clinical definition for a probable case of chancroid includes all of the following:

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Patient has one or more painful genital ulcers. The combination of a painful ulcer with tender adenopathy is suggestive of chancroid; the presence of suppurative adenopathy is almost pathognomonic.

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No evidence of Treponema pallidum is indicated by dark-field examination of ulcer or by a serologic test for Syphilis performed at least 7 days after the onset of ulcer.

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The clinical presentation is not typical of disease caused by human herpesvirus 2 (Herpes Simplex Virus), or result of culture for HSV is negative.

About half of infected men have only a single ulcer. Women frequently have four or more ulcers, with fewer symptoms. The ulcers appear in specific locations, such as the coronal sulcus of the uncircumcised glans penis in men, or the fourchette and labia minora in women. Common locations in men (from most common to least common)

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

Common locations in women In women the most common location for ulcers is the labia majora. "Kissing ulcers" may develop. These are ulcers that occur on opposing surfaces of the labia. Other areas such as the labia minora, perineal area, and inner thighs may also be involved. The most common symptoms in women are pain with urination and pain with intercourse. The initial ulcer may be mistaken as a "hard" chancre, the typical sore of primary syphilis, as opposed to the "soft chancre" of chancroid. Approximately one third of the infected individuals will develop enlargements of the inguinal lymph nodes, the nodes located in the fold between the leg and the lower abdomen. Half of those who develop swelling of the inguinal lymph nodes will progress to a point where the nodes rupture through the skin producing draining abscesses. The swollen lymph nodes and abscesses are often referred to as buboes. Treatment The CDC recommendation for chancroid is a single oral dose of Azythromicin or a single IM dose of Ceftriaxone or oral Erythromycin for seven days.

Granuloma inguinale (GI) Background: Granuloma inguinale (GI) is primarily a sexually transmitted disease in which characteristic intracellular inclusions called Donovan bodies may be seen. It usually manifests as genital lesions, which are indolent, progressive, ulcerative, and granulomatous. Pathophysiology: GI is caused by Calymmatobacterium granulomatis, a gram-negative pleomorphic bacillus. The mode of transmission is primarily through sexual contact, although GI may be obtained through a fecal route or by passage through an infected birth canal. It is considered to be only mildly contagious, and repeated exposure may be necessary for clinical infection to occur. Frequency:

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In the US: Fewer than 100 cases are reported annually, many of which are thought to be due to foreign travel.

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Internationally: GI is endemic in Western New Guinea, the Caribbean, Southern India, South Africa, Southeast Asia, Australia, and Brazil.

Mortality/Morbidity: Untreated, the disease will most likely not remit, and the lesions may continue to expand for years (see Complications). Race: The racial predilection is most likely due to socioeconomic status and living conditions rather than a racial susceptibility.

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The incidence is higher in blacks than in whites in the United States.

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The incidence is higher in natives than in Europeans in Western New Guinea.

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The incidence is higher in Hindus than in Moslems in India.

Sex: No sexual predominance exists. Age: The highest incidence occurs in persons aged 20-40 years.

Lymphogranuloma venereum

What is lymphogranuloma venereum (LGV)? LGV is a sexually transmitted disease (STD) or infection involving the lymph glands in the genital area. It is caused by a specific strain of Chlamydia. Who gets LGV? The incidence is highest among sexually active people living in tropical or subtropical climates. It has also occurred in some areas of the southern United States. How is LGV spread? The infection is spread by sexual contact. What are the symptoms of LGV? The first symptom may be a small, painless pimple or lesion occurring on the penis or vagina. It is often unnoticed. The infection then spreads to the lymph nodes in the groin area and from there to the surrounding tissue. Complications may include inflamed and swollen lymph glands which may drain and bleed. How soon do symptoms appear? The onset of symptoms varies widely. The initial lesion may appear from three to 30 days after exposure. When and for how long is a person able to spread LGV? An individual remains infectious as long as there are active lesions. What is the treatment for LGV? Treatment involves the use of certain antibiotics, specifically tetracycline or sulfamethoxazole. What can be done to prevent the spread of LGV? There are a number of ways to prevent the spread of LGV:

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Limit your number of sex partners. Use a male or female condom. Carefully wash genitals after sexual relations. If you think you are infected, avoid any sexual contact and visit your local STD clinic, a hospital or your doctor. Notify all sexual contacts immediately so they can obtain examination and treatment.

amoeba is a single-celled microscopic organism that has no solid body structure. Numerous species of amoebae can live as parasites inside the human intestines, but only one is known to cause disease - Entamoeba histolytica (E. histolytica), and the disease it causes is known as amebiasis.

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