Buboes Without Ulcers

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This usually occurs in persons with lymphogranuloma venereum (LGV) which is caused by the L-types of Chlamydia trachomatis. The main effect of the infection is on the lymphatics and patients may present with penile and vulval lymphoedema together with inguinal buboes. Rectal LGV infection can also present with anal discharge and may be confused with inflammatory bowel disease. A small transient genital ulcer, which may heal on its own, may precede the swelling and buboes. The bubo is typically multilocular and may be grooved by the inguinal ligament.

First Line:

Medicine	Adult dose	Frequency	Duration
doxycycline po	100mg	twice a day	21 days

Second line, or in pregnant women:

Medicine	Adult dose	Frequency	Duration
erythromycin po	500mg	4 times a day	for 21 days