[Question #13531] Clarification for Question #13517

1 months ago

Hello Dr

I asked a question last week that left me bittersweet and somehow confused since then. This is not an anxiety driven question rather a clarification question. Please refer to my question #13517 for reference.

I Asked if it’s possible to have chancroid without symptoms and dr Hhh answered that there is no such thing as asymptomatic chancroid, but also noted that Hemophilus ducreyi has sometimes been identified in the genital area in absence of genital ulcer.

My confusion rest in a fact that how is it possible that there is no such thing as asymptomatic chancroid but sometimes there is asymptomatic hemophilus ducreyi ? Aren’t they the same ? and why testing is not recommended to prevent asymptomatic H. Ducreyi?

Bottom line I understand your answer on the other thread saying that '' If you don't have open genital sore (ulcers), you do not have chancroid and do not need testing for it. Period, no exceptions.'' , But i just wanted to clear that up

H. Hunter Handsfield, MD

1 months ago

Welcome back, but I'm sorry you found it necessary. Your own "bottom line" is exactly right and seems to show you are not confused at all. What don't you understand about it?

In other words, asymptomatic Hemophilus ducreyi and chancroid are NOT the same. To repeat our previous discussion, "chancroid" means genital ulcer (or sometimes skin ulcer in other locations) due to H. ducreyi. Therefore, if there is no ulcer, that person is not considered to have chancroid even if they happen to be carrying H. ducreyi.

OK?

HHH, MD

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1 months ago

You couldn't be more clear! thanks!
as for Hemophilus ducreyi in itself (the bacteria): if it's present but there are no ulcers, then It is not considered an STI in that situation. correct?

H. Hunter Handsfield, MD

1 months ago

Be clear: there has been little or no research on asymptomatic H. ducreyi, how frequently it happens, etc. Some chancroid is transmitted by nonsexual personal contact, e.g. reports of cases in children or others who were not sexually active. Testing is done rarely if ever in absence of symptoms, but if for some reason it were done with a positive result, I certainly would ask the patient about sexual exposure risks but would not necessarily consider that they had an STI. Anyway, this is all in the realm of speculative semantics!

That completes the two follow-up comments and replies included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.

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