Inguinal Swelling (Bubo)

exp date isn't null, but text field is

It is an STI syndrome presenting as localised swellings or enlarged lymph glands in the groin and femoral area.

Causes

  • Chlamydia strains: lymphogranuloma venerium (LGV)
  • Heamophilus ducreyi: chancroid
  • Treponema pallidum: syphilis

Clinical features

  • Excessively swollen inguinal glands
  • Pain, tenderness
  • Swellings may become fluctuant if pus forms

Differential diagnosis

  • Other causes of swollen inguinal lymph nodes, e.g. leg ulcer
  • Obstructed inguinal hernia

Investigations

  • As for Genital Ulcers
  • C&S of pus

Management

Management

TREATMENT LOC

Examine for genital ulcers, rule out infection of the foot, leg or buttock and exclude inguinal hernia

  • If genital ulcer is present, treat as per above protocol
  • Give doxycycline 100 mg 12 hourly for 14 days
  • Treat partner

If partner is pregnant

  • Give erythromycin 500 mg every 6 hours for 14 days

If bubo persisting, and partner was not treated

  • Continue treatment for 14 days

If not improving

  • Refer for specialist management

HC2

HC3

 

Caution

  • Do not incise bubo. Aspirate through normal skin with a large bore needle gauge <20 every 2 days until resolution
  • Alternative to doxycycline: azithromycin 1 g single dose