Chancroid may occur in regional outbreaks and presents with a painful genital ulcer and suppurative regional ade-nopathy. Herpes and syphilis should both be ruled out in the patient suspected of having chancroid infection. Chancroid is caused by Haemophilus ducreyi and there is currently no FDA approved test to directly detect this organism. Treatment with azithromycin (1 g as single dose), ceftriaxone (250 mg IM as a single dose), ciprofloxacin (500 mg twice daily for 3 days), or erythromycin (500 mg three times daily for 7 days) are all alternatives (Table 16-10). It may be necessary to perform incision and drainage on fluctuant inguinal nodes. Patients should be reexamined in 1 to 2 weeks to ensure healing of the primary ulcer(s) and resolution of the adenopathy. Partners who had contact with the infected patient starting 10 days before development of the patient's symptoms should be treated, regardless of the presence of symptoms.

Table 16-10 Treatment of Chancroid, Lymphogranuloma Venereum, and Granuloma Inguinale

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