Pathogen

• Haemophylus ducrei (Anaerobic gram negative bacillus)

Epidemiology

• Mainly core groups (associated with promiscuity, sex work, poor hygiene)

• Common in Africa, Asia, Central and South America - incidence appears to have decreased since onset of HIV epidemic

Clinical

• Incubation period <10 days

• Asymptomatic infection rare

• Papule > pustule > painful genital ulceration > auto-innoculation > multiple ulcers > suppurative inguinal buboes

Diagnosis

• Visualise bacteria: Gram smear (poor sensitivity, sensitivity), culture (on selective media), approx. 50% sensitivity

• Nucleic acid detection: in research settings

Management

• Azithromycin, erythromycin, ciprofloxacin...(generally resistant to penicillins, tetracyclines)