A 23-year-old man comes to the physician because of an ulcer on his penis. He reports a painful ulcer and draining yellow purulent material. He returned from a study abroad trip to India 3 months ago. His immunizations are up-to-date. He is sexually active with one female partner and uses condoms inconsistently. He appears uncomfortable. His temperature is 37.2°C (99.0°F), pulse is 94/min, and blood pressure is 120/80 mm Hg. Examination shows tender inguinal lymphadenopathy. There is a 2-cm ulcer with a necrotic base proximal to the glans of the penis. Which of the following is the most likely diagnosis?

Question

A 23-year-old man comes to the physician because of an ulcer on his penis. He reports a painful ulcer and draining yellow purulent material. He returned from a study abroad trip to India 3 months ago. His immunizations are up-to-date. He is sexually active with one female partner and uses condoms inconsistently. He appears uncomfortable. His temperature is 37.2°C (99.0°F), pulse is 94/min, and blood pressure is 120/80 mm Hg. Examination shows tender inguinal lymphadenopathy. There is a 2-cm ulcer with a necrotic base proximal to the glans of the penis.   Which of the following is the most likely diagnosis?

Quizplus · Accepted Answer

Eductional Objective: Chancroid is a sexually transmitted infection caused by the gram-negative bacillus Haemophilus ducreyi. This condition manifests with a very painful lesion that is typically 2-cm in size and clearly demarcated with a greyish necrotic base. In men, a single lesion is common, while in women multiple lesions may be present. In addition, chancroid is often accompanied by painful inguinal lymphadenopathy. Treatment of chancroid is with single-dose oral azithromycin or intramuscular ceftriaxone.

A 23-Year-Old Man Comes to the Physician Because of an Ulcer