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Chancroid is a genital ulcer infection caused by Haemophilus ducreyi and is found mainly in developing countries. The highest prevalences are reported from southern, central, and eastern Africa. The importance of chancroid as a risk factor for heterosexual HIV transmission in developing countries is well recognised.1, 2 Chancroid is also associated with an increased risk of HIV in the United States.3, 4
Significant outbreaks of chancroid have been reported in recent times in Canada and the United States.5, 6 These epidemics have usually been associated with commercial sex work. Recent outbreaks have been associated with syphilis, an increased risk of HIV infection, and the use of crack cocaine.7, 8 Control measures have centred around improved surveillance and contact tracing. The development of the Roche multiplex polymerase chain reaction (M-PCR) assay for H ducreyi has enabled the diagnosis of chancroid to be made in settings where ready access to culture techniques for H ducreyi was previously unavailable. In a recent 10 city study, chancroid was confirmed in 12% of genital ulcers in Chicago and 20% in Memphis.9
In the United Kingdom, the reported number of cases of chancroid in recent years has never …