STI-related Inguinal Bubo

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Cause

  • Chlamydia trachomatis (Lymphogranuloma venereum)
  • Haemophilus ducreyi (Chancroid)

Symptoms

  • Painful or painless inguinal swelling(s)

Signs

  • Inguinal swellings:
    • unilateral or bilateral
    • tender or non-tender
    • fluctuant
    • suppurating
  • Genital ulcer

Investigations

  • No investigations required, in view of the syndromic approach
  • Recommended in managing STIs

TreatmentTreatment Objectives

  • To relieve pain
  • To relieve the swelling
  • To treat the infection of lymphogranuloma venereum and chancroid concurrently 

Non-pharmacological treatment

  • Aspiration of fluctuant buboes using a wide bore needle through adjacent healthy skin every second or third day. An incision and drainage should not be attempted. If  buboes persist, the patient should be referred.
  • Sequelae such as strictures and/or fistula may require surgery.

Pharmacological treatment

For Lymphogranuloma Venereum (LGV) and Chancroid

Evidence Rating: [C]

  • Doxycycline, oral, 100 mg 12 hourly for 21 days

Or

  • Azithromycin, oral, 1 g stat.

Or

  • Erythromycin, oral, 500 mg 6 hourly for 14 days