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Sexually transmitted infections are a common problem worldwide. A typical presentations may sometimes occur so Chancroid should always be kept in mind as a differential diagnosis while dealing with genital ulcer disease (GUD) patients as Microbiological evidence may not always be available. We present two cases with GUD. Swabs were collected from the base and margins of the penile ulcers and sent to the bacteriology laboratory for Gram staining and aerobic routine culture. Gram-stained smears revealed numerous Gram-negative coccobacilli in a typical railroad track/school of fish appearance suggestive of Haemophilus ducreyi infection. No growth was observed on aerobic routine culture. The patients were started on single-dose azithromycin as per National AIDS Control Organisation (NACO) guidelines. Remarkable clinical improvement was observed in both patients on follow-up.

Sexually transmitted infections are a common problem worldwide. A typical presentations may sometimes occur so Chancroid should always be kept in mind as a differential diagnosis while dealing with genital ulcer disease (GUD) patients as Microbiological evidence may not always be available. We present two cases with GUD. Swabs were collected from the base and margins of the penile ulcers and sent to the bacteriology laboratory for Gram staining and aerobic routine culture. Gram-stained smears revealed numerous Gram-negative coccobacilli in a typical railroad track/school of fish appearance suggestive of Haemophilus ducreyi infection. No growth was observed on aerobic routine culture. The patients were started on single-dose azithromycin as per National AIDS Control Organisation (NACO) guidelines. Remarkable clinical improvement was observed in both patients on follow-up. [ABSTRACT FROM AUTHOR]

SUMMARYChancroid, a sexually transmitted infection caused by Haemophilus ducreyi , is characterized by painful genital ulcers (GU) and inguinal lymphadenitis. H. ducreyi was recently described as a major cause of non-sexually transmitted cutaneous ulcers (CU) on the lower legs in children in yaws-endemic regions. This review explores the relationship between CU and GU strains of H. ducreyi ; their clinical presentation, diagnosis, epidemiology, and treatment; and how findings from a human challenge model relate to GU and CU. We contrast the decline of GU with the persistence of CU caused by H. ducreyi . Factors such as transmission dynamics, control, and elimination efforts are discussed. Syndromic management and targeted treatment of sex workers can eradicate chancroid, while skin colonization by CU strains and environmental factors may necessitate topical treatments or vaccination for CU eradication. Efforts should focus on identifying additional reservoirs of CU strains, improving hygiene, and eliminating asymptomatic colonization to eradicate this painful infection in children.

Rollet's Mixed Chancre is a clinical presentation of sexually transmitted infections (STI), involving the coexistence of Haemophilus ducreyi and Treponema pallidum at the same site of infection. Here, we report a case of Rollet's Mixed Chancre in a 32-year-old Brazilian woman. On physical examination she presented with a unilateral bubo measuring approximately 5 × 3 centimeters in diameter, in association with an ulcerated lesion that evolved for 10 days at the inguinal region. She was successfully treated at a health unit with antibiotics. Rollet's Mixed Chancre, though uncommon, poses diagnostic challenges. This case highlights the importance of considering rare STI manifestations. Moreover, comprehensive STI screening and adherence to treatment guidelines are essential for effective management and prevention of further transmission., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Haemophilus ducreyi causes the genital ulcer disease chancroid and painful cutaneous ulcers in children who live in the tropics. To acquire heme from the host, H. ducreyi expresses a TonB-dependent hemoglobin receptor, HgbA, which is necessary and sufficient for H. ducreyi to progress to the pustular stage of disease in a controlled human infection model. HgbA transports hemoglobin across the outer membrane; how heme is transported across the cytoplasmic membrane is unclear. In previous studies, transcripts encoding the YfeABCD heme transporter were upregulated in experimental lesions caused by H. ducreyi in human volunteers, suggesting the latter may have a role in virulence. Here we constructed a double deletion mutant, 35000HPΔ yfeAB Δ yfeCD , which exhibited growth defects relative to its parent 35000HP in media containing human hemoglobin as an iron source. Five human volunteers were inoculated at three sites on the skin overlying the deltoid with each strain. The results of the trial showed that papules formed at 100% (95% CI, 71.5, 100) at both 35000HP and 35000HPΔ yfeAB Δ yfeCD -inoculated sites ( P = 1.0). Pustules formed at 60% (95% CI, 25.9, 94.1) at parent-inoculated sites and 53% (95% CI, 18.3, 88.4) at mutant-inoculated sites ( P = 0.79). Thus, the ABC transporter encoded by yfeAB and yfeCD was dispensable for H. ducreyi virulence in humans. In the absence of YfeABCD, H. ducreyi likely utilizes other periplasmic binding proteins and ABC-transporters such as HbpA, SapABCDF, and DppBCDF to shuttle heme from the periplasm into the cytoplasm, underscoring the importance of redundancy of such systems in gram-negative pathogens., Competing Interests: The authors declare no conflict of interest.

Cutaneous ulcers are common in yaws-endemic areas. Although often attributed to ' Treponema pallidum subsp. pertenue' and Haemophilus ducreyi , quantitative PCR has highlighted a significant proportion of these ulcers are negative for both pathogens and are considered idiopathic. This is a retrospective analysis utilising existing 16S rRNA sequencing data from two independent yaws studies that took place in Ghana and the Solomon Islands. We characterized bacterial diversity in 38 samples to identify potential causative agents for idiopathic cutaneous ulcers. We identified a diverse bacterial profile, including Arcanobacterium haemolyticum , Campylobacter concisus , Corynebacterium diphtheriae , Staphylococcus spp . and Streptococcus pyogenes , consistent with findings from previous cutaneous ulcer microbiome studies. No single bacterial species was universally present across all samples. The most prevalent bacterium, Campylobacter ureolyticus , appeared in 42% of samples, suggesting a multifactorial aetiology for cutaneous ulcers in yaws-endemic areas. This study emphasizes the need for a nuanced understanding of potential causative agents. The findings prompt further exploration into the intricate microbial interactions contributing to idiopathic yaw-like ulcers, guiding future research toward comprehensive diagnostic and therapeutic strategies.