A 25-year-old man presents with painful genital ulcers with ragged undermined edges, a purulent base, and painful inguinal lymphadenopathy (bubo). Culture on chocolate agar with vancomycin yields Gram-negative coccobacilli. What is the FIRST-LINE treatment currently recommended?
- A Azithromycin 1 g orally single dose ✓
- B Benzathine penicillin 2.4 MU IM single dose
- C Ceftriaxone 250 mg IM single dose
- D Doxycycline 100 mg twice daily for 3 weeks
Correct answer: A. Azithromycin 1 g orally single dose
Explanation
This describes chancroid caused by Haemophilus ducreyi. Current WHO/CDC guidelines recommend azithromycin 1 g orally as a single dose as the preferred regimen due to convenience and efficacy. Alternatives include ceftriaxone 250 mg IM single dose or ciprofloxacin 500 mg twice daily for 3 days (but increasing resistance). Erythromycin 500 mg TDS for 7 days is another option. Doxycycline for 3 weeks is used for lymphogranuloma venereum (LGV), not chancroid. Benzathine penicillin is for syphilis.
Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.