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