Chancre mou

Chancroid (also known as soft chancre and ulcus molle) is a sexually transmitted disease (STD) due to the Ducrey’s bacillus (or Haemophilus ducreyi) characterized by chancre at the site of ulcerated inoculation associated with lymphadenopathy. The disease manifests as a small pinkish papule at the site of penetration of the bacterium. After an incubation period ranging from 24 hours to 15 days (on average 5 days). The lesion rapidly evolves into a more or less extended pinkish, painful, deep ulcer with very inflamed and sharp edges and a ragged appearance. The lymphadenopathies usually occur 2-3 weeks after the contact. They are often unilateral and can evolve into ulcers with pus discharge at the level of the skin. Some complications can occur: penile gangrene, extended gangrene of the skin, local superinfection, association with other sexually transmitted diseases. Bacterium can be identified by microscopic examination of a smear of the chancre-like ulcer, more rarely by fine-needle puncture biopsy of a lymphadenopathy. Giemsa or Pappenheim coloration allows identification of the germ. Treatment is based on azithromycin (1 g per os in a single dose) or ceftriaxone (250 mg administered intramuscularly in a single dose). We report the case of a 30-year old man with well-defined deep scrotum ulcer with necrotic center which occurred 1 week after unprotected sexual intercourse. Haemophilus ducrey has been detected by culture and the patient underwent Azithromycin therapy with good outcome.