ANSWER:
Chlamydia trachomatis
EXPLANATION:
This patient is presenting with the classic features of Lymphogranuloma venereum (LGV). This tropical sexually
transmitted disease can be caused by multiple serovars of
Chlamydia Trachomatis. The bacterium gains entry through
breaches in the epithelial/mucous membranes, travelling
through the lymphatics via macrophages to local nodes. It is
endemic to Africa, India, Caribbean, central America and southeast Asia.
The disease presents in two stages:
Primary stage: Self-limiting painless genital ulcer at the site
of inoculation 3-12 days later.
Secondary stage: Presents 1-6 months later with unilateral
painful lymphadenitis/lymphangitis. The site of inoculation
dictates symptomatology, if rectally, then tenesmus, proctocolitis, strictures and fistulas can ensue. Cervicitis and urethritis are also common features. Enlarged lymph nodes are known as buboes, they are often painful and can lead to
thinning of the overlying skin causing abscesses. Groove sign
is separation inguinal nodes by the inguinal ligament and is characteristic of the disease.
Diagnosis is achieved by enzyme linked immunoassays or
polymerase chain reaction of infected sample areas/pus.
Acute and convalescent sera can be used, but requires two
samples 2 weeks apart.
Treatment involves antibiotics, either doxycycline or macrolides (azithromycin or erythromycin) and potential surgical drainage/aspiration of the buboes or abscesses. Complications of the disease include: genital area elephantiasis, hepatitis, infertility, pelvic inflammatory disease, arthritis and fitz hugh curtis syndrome.
This Channel is Created for Case Based MCQs from FIRST AID Book 🎖🏆 You will get MCQs, previous year Questions, important PDFs and etc...
CASES :- @CASEBASEDSTUDY
MCQs:- @CASEBASEDMCQs
November 29, 2023 1.3K 2
