Chancroid and Lymphogranuloma Venereum

Chancroid and lymphogranuloma venereum are sexually transmitted infections characterized by genital ulceration and lymphadenitis. Chancroid is caused by the Gram-negative coccobacillus Haemophilus ducreyi, and is a significant cause of genital ulcer disease in resource-limited settings (RLS). Its overall prevalence is probably underestimated due to a lack of availability of laboratory diagnostics in many areas of the world. Definitive diagnosis of chancroid is by isolation of H. ducreyi by culture or polymerase chain reaction. Recommended treatment is single-dose azithromycin 1 g orally or ceftriaxone 250 mg intramuscularly. Lymphogranuloma venereum (LGV) is caused by Chlamydia trachomatis serovars L1, L2, and L3. Infection is characterized by genital ulceration with associated lymphadenopathy. Outbreaks of proctitis caused by LGV serovar L2 have been well described in the population of men who have sex with men. Recommended treatment is with doxycycline 100 mg orally twice daily for 21 days.