Chancroid in a 38-Year-Old Man

A 38-year-old man presented with multiple painful penile ulcerations, as well as tender, bilateral inguinal adenopathy. He had returned from a trip to Africa a week before presentation.

Key point: Although primary syphilis might be considered, the multiplicity of lesions and associated pain are not typical of lues. Because of his recent travel history, the lesions were cultured, and Haemophilus ducreyi was isolated, confirming the clinical suspicion of chancroid.

Treatment: The problem resolved following an intramuscular injection of ceftriaxone.

Note: This sexually transmitted disease is rarely encountered in the United States, but is common in Africa and parts of Asia. Always ask a travel history when considering exotic diseases.