tetracycline and Chancroid

Chancroid, an ulcerous disease of the genitalia caused by Haemophilus ducreyi, occurs rarely but regularly in Germany. Exact diagnosis is based on the clinical features and a direct smear, and in particular on cultivation of the organism, showing its unique macromorphological characteristics. The sensitivity of cultivation has increased due to the development of selective media for primary isolation. Resistance problems during the last decade meant that a change to new therapeutic strategies was unavoidable. The work presented here includes a case report and a review of the recent literature, it illustrates modern methods of diagnosis and treatment of Haemophilus ducreyi infections 100 years after the first description of the organism.

Topics: Administration, Topical; Bacteriological Techniques; Balanitis; Ceftriaxone; Chancroid; Drug Therapy, Combination; Haemophilus ducreyi; Humans; Injections, Intramuscular; Male; Microbial Sensitivity Tests; Middle Aged; Tetracycline

Topics: Ampicillin; beta-Lactamases; Chancroid; DNA, Bacterial; Haemophilus ducreyi; Humans; Neisseria gonorrhoeae; Penicillin Resistance; Penicillins; Plasmids; Sulfonamides; Tetracycline

Topics: Anti-Bacterial Agents; Chancroid; Female; Gonorrhea; Granuloma Inguinale; Humans; Infant; Infant, Newborn; Lymphogranuloma Venereum; Male; Penicillins; Pregnancy; Sexually Transmitted Diseases; Syphilis; Syphilis, Congenital; Tetracycline

Topics: Chancroid; Diagnosis, Differential; Female; Haemophilus; Humans; Lymphatic Diseases; Male; Sulfonamides; Tetracycline

Thirty-five men with chancroid were randomly treated with oral sulfisoxazole, sulfisoxazole and tetracycline, sulfamethoxazole-trimethoprim, or intramuscular streptomycin. The highest rate of cures were obtained in 13 of 13 patients treated with streptomycin and in ten of ten patients treated with sulfamethoxazole-trimethoprim. Only seven of nine patients treated with sulfisoxazole and five of eight treated with sulfisoxazole and tetracycline were cured. We conclude that the sulfamethoxazole-trimethoprim combination is as efficacious as streptomycin and probably superior to sulfisoxazole and tetracycline in the treatment of chancroid.

Topics: Chancroid; Clinical Trials as Topic; Drug Therapy, Combination; Humans; Male; Random Allocation; Streptomycin; Sulfamethoxazole; Sulfisoxazole; Tetracycline; Trimethoprim

Topics: Adult; Chancroid; Humans; Male; Military Medicine; Sulfisoxazole; Tetracycline; United States; Vietnam

One-hundred thirteen men (mean age, 23 years) who presented with inguinal buboes to a government-operated hospital for sexually transmitted diseases (STDs) in Bangkok were studied between February 1987 and February 1989. The median duration of preceding symptoms was 7 days (range, 1-62 days). The majority of patients (74; 65%) had received treatment previously; 31 (27%) were febrile, 13 (12%) had extrainguinal lymphadenopathy, and 31 (27%) had concurrent active genital ulcers. There was no history of genital ulceration in 66 (58%) of the patients. Pus was obtained from 51 of the 110 buboes aspirated for culture; 21 (41%) of these cultures yielded Haemophilus ducreyi, and 2 (3.9%) were positive for Chlamydia trachomatis on immunofluorescence microscopy. Saline (1 mL) was injected and reaspirated from the buboes of 35 of the other 59 patients; 3 buboes yielded H. ducreyi and 9 were positive for C. trachomatis. All cultures for other aerobic and anaerobic bacteria and viruses in intact buboes were negative. Syphilis serology was positive in only one case. Patients attending STD clinics in this region who have large, fluctuant, edematous inguinal buboes containing pus should receive presumptive treatment for chancroid. If there is no pus, then the bubo is more likely to be caused by lymphogranuloma venereum.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Chancroid; Chlamydia trachomatis; Erythromycin; Haemophilus ducreyi; Humans; Lymph Nodes; Lymphogranuloma Venereum; Male; Prospective Studies; Tetracycline; Thailand

A case of an HIV positive man with multiple sexually acquired disease occurring concurrently is described. Risk behaviours that could have predisposed him to HIV infection are discussed. The factors which might have interacted to make the sexually acquired infections severe and difficult to treat are postulated.. The case of an HIV-seropositive man with gonorrhea, syphilis, genital warts, and chancroid is described. Multiple sexual partners, genital ulcer diseases, and lack of circumcision may have predisposed him to HIV infection. As indicated by his CD4/CD8 ratio of 0.5, his immunological status was not very compromised. Other factors were therefore probably behind these multiple sexually transmitted diseases (STD). This 30-year old man was inadequately treated for a long time for urethral discharge and genital ulcer disease, and ultimately collapsed on the job with a comprised central nervous system. Bacterial infection related to the multiple STDs could certainly have caused this collapse. The time demands of this man's work, the lack of medical facilities to diagnose and treat such conditions, his unprotected sexual behavior with multiple partners, and broader socioeconomic conditions which separate wage- earning males from their families in Africa conspire to produce multiply-afflicted cases such as these.

Topics: Adult; Anti-Infective Agents; Chancroid; Ciprofloxacin; Condylomata Acuminata; Gonorrhea; HIV Seropositivity; Humans; Injections, Intravenous; Kenya; Male; Risk Factors; Sexually Transmitted Diseases; Syphilis; Tetracycline

A case of Hemophilus ducreyi infection clinically resembling granuloma inguinale is reported. Culture of the causative organism permitted a definitive diagnosis to be made. Combined treatment with tetracycline and sulphamethizole/trimethoprim rapidly cleared the infection.

Topics: Adult; Chancroid; Diagnosis, Differential; Drug Combinations; Drug Therapy, Combination; Granuloma Inguinale; Humans; Male; Skin Ulcer; Tetracycline; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Adolescent; beta-Lactamases; Chancroid; Haemophilus ducreyi; Humans; Lymecycline; Male; Microbiological Techniques; New Zealand; Penicillin Resistance; Tetracycline

Topics: Adult; Chancroid; Drug Resistance, Microbial; Humans; Kanamycin; Male; Sulfisoxazole; Tetracycline

Of 97 patients with genital ulcers attending a special treatment clinic in Nairobi, Kenya, 60 harboured Haemophilus ducreyi, four herpes simplex virus, and five Neisseria gonorrhoeae. Eleven patients had serological evidence of syphilis; of these one case was confirmed by darkfield microscopy. In the remaining cases no aetiological agent was identified. An enriched chocolate agar with vancomycin and serum was a useful medium for primary isolation of H ducreyi. Tetracycline was generally ineffective in the treatment of ulcers, but sulfadimidine was successful in almost 80% of cases.

Topics: Adult; Chancroid; Female; Genital Diseases, Male; Haemophilus ducreyi; Humans; Kenya; Male; Neisseria gonorrhoeae; Sulfamethazine; Tetracycline; Ulcer

The improved control over most infectious disease does not extend to venereal infections, and these now provide the major medical problem encountered in wartime. This factor should be recognized when staff and facilities are being provided for wartime medical services. Unique problems of management of both physical and psychological illness may result from promiscuity in a foreign land during war, and specialist venereologists are as necessary as surgeons and physicians.

Topics: Australia; Chancroid; Drug Resistance, Microbial; Humans; Male; Military Medicine; Penile Diseases; Seasons; Sexually Transmitted Diseases; Skin Ulcer; Streptomycin; Sulfisoxazole; Tetracycline; Urethritis; Vietnam; Warfare; Warts

Topics: Chancroid; Drug Combinations; Erythromycin; Female; Gonorrhea; Granuloma Inguinale; Humans; Injections, Intramuscular; Kanamycin; Lymphogranuloma Venereum; Male; Metronidazole; Penicillin Resistance; Penicillins; Rifampin; Sexually Transmitted Diseases; Streptomycin; Sulfamethoxazole; Sulfonamides; Syphilis; Tetracycline; Trimethoprim; Urethritis

Topics: Administration, Oral; Biopsy; Chancroid; Drug Tolerance; Evaluation Studies as Topic; Hospitalization; Humans; Lymphogranuloma Venereum; Methylamines; Sexually Transmitted Diseases; Staining and Labeling; Syphilis; Tetracycline; Time Factors

Topics: Anti-Bacterial Agents; Chancroid; Granuloma Inguinale; Humans; Lymphogranuloma Venereum; Pathology; Podophyllum; Sexually Transmitted Diseases; Tetracycline

Topics: Anti-Bacterial Agents; Chancroid; Gonorrhea; Humans; Lymphogranuloma Venereum; Sexually Transmitted Diseases; Tetracycline