A colleague came into the charting area and said he thought he had just seen his first case of chancroid. He asked me if I had a moment to see the patient, a 32-year-old African American man who noted the onset of painful sores on his penis 1 week ago. The patient consented to a second opinion. On further questioning, he remembered a tingling pain that started a few days prior to the sores. When asked about any previous outbreaks, he thought he may have had something like this 1 year ago. He did not remember seeing blisters before the sores appeared.
The last time the patient had sexual relations was 2 months ago, with someone he met at a party. He claimed he used a condom. He did not have any lesions at that time and had never had a sexually transmitted disease before.
He had recently fallen in love, and was concerned about these ulcers—he did not want to give her any diseases. They had only kissed so far and he wanted to know what he should tell her. He said he had never had sex with men or injected any drugs. He has had a number of serially monogamous relationships and reported no other human immunodeficiency virus (HIV) risk factors.
The patient was a healthy-looking young man. Examination of his penis (Figure 1) showed the ulcers clearly visible (Figure 2). He had only shotty inguinal adenopathy that was nontender.
FIGURE 1
Painful sores on the genitals
FIGURE 2
Close-up of ulcers on the penis
What is the diagnosis?
What is the treatment and prevention strategy?