a 20 yr old man developed a small transient genital ulcer 4weeks after exposure the regional lymphnodes enlarged, tender and adherent to the deep tissues.fever ,weight loss and hepatospleenomegaly are present the diagnosis is ?
Correct Answer: LGV
Description: Lymphogranuloma venereum (LGV): * Invasive infection caused by serovars: Ll, L2, and L3. * Clinical presentation: o Papules and then herpetic-like ulcers are formed on the external genitalia and persist for one to two months (more invasive infection). o Painful swelling of inguinal and perirectal lymph nodes (bubo). Cervical adenopathy (oral sex) o Lymphatic obstruction; elephantiasis of genitalia. DD of genital ulcers: chancer, chancroid, genital herpes, trauma, drug sensitivity. Treatment LGV can be treated with specific antibiotics. If left untreated, LGV can spread to the lymph nodes and cause genital and anal ulceration or scarring. In severe cases, it can lead to death. REF : thomas habif 7th ed
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