Though it's most prevalent in developing and Third World countries, it's found all over the globe. The infection is less common in circumcised men than in those who are not circumcised, but any sexually active person can get it. In the United States fewer than 1,500 cases are reported annually, but since chancroid is hard to diagnose, experts think it's underreported. Within three to seven days of exposure, one or more small bumps will form on or near the genitals. Within a day these bumps will become painful open sores, ranging in size from an eighth of an inch to 2 inches in diameter.
Many people also experience achingly swollen lymph glands in the groin.
Sometimes this swelling continues until the lymph nodes rupture through the skin and form abscesses called buboes. Some women don't develop sores, but experience other symptoms such as soreness during urination or defecation, vaginal discharge, severely painful intercourse, or rectal bleeding. Because the lesions are similar to those caused by herpes and syphilis, the diagnostic procedure for chancroid isn't straightforward. Culturing H. ducreyi in a lab is difficult, so doctors begin by ruling out herpes and syphilis. If both tests are negative, additional screening may be necessary.