A Prospective Clinical and Bacteriologic Study of Inguinal Buboes in Thai Men

Abstract

One-hundred thirteen men (mean age, 23 years) who presented with inguinal buboes to a government-operated hospital for sexually transmitted diseases (STDs) in Bangkok were studied between February 1987 and February 1989. The median duration of preceding symptoms was 7 days (range, 1-62 days). The majority of patients (74; 65%) had received treatment previously; 31 (27%) were febrile, 13 (12%) had extrainguinal lymphadenopathy, and 31 (27%) had concurrent active genital ulcers. There was no history of genital ulceration in 66 (58%) of the patients. Pus was obtained from 51 of the 110 buboes aspirated for culture; 21 (41%) of these cultures yielded Haemophilus ducreyi, and 2 (3.9%) were positive for Chlamydia trachomatis on immunofluorescence microscopy. Saline (1 mL) was injected and reaspirated from the buboes of 35 of the other 59 patients; 3 buboes yielded H. ducreyi and 9 were positive for C. trachomatis. All cultures for other aerobic and anaerobic bacteria and viruses in intact buboes were negative. Syphilis serology was positive in only one case. Patients attending STD clinics in this region who have large, fluctuant, edematous inguinal buboes containing pus should receive presumptive treatment for chancroid. If there is no pus, then the bubo is more likely to be caused by lymphogranuloma venereum.

Inguinal syndrome secondary toPrevotella biviaafter accidental bite in orogenital sex

“…The most frequent aetiological agent was Haemophilus ducreyi followed by C trachomatis 2. The outbreak of lymphogranuloma venereum (LGV) in large cities of Europe and America has to be taken into account in the management of the inguinal syndrome.…”

Lymphogranuloma venereum – the first Hungarian cases

“…Az antibiotikumok alkalmazásának széles körű elterjedésével az ezredfordulót megelőzően LGVmegbetegedéseket a fejlett országokban csak elvétve jelentettek [6], és ezek többnyire behurcolt esetek voltak. Ugyanakkor a kórokozó által terjesztett betegség a fejlő-dő országokban (karibi térség, Dél-Amerika, Thaiföld, India, Kelet-és Nyugat-Afrika) a H. ducreyi okozta ulcus molle (chancroid) után, fontos betegség maradt, a genitális fekélyek 1-10%-át okozva [7].…”

“…A "klasszikus" és az "anorectalis" formára jellemző tüneteket a 1. táblázat mutatja be. A "klasszikus" kép esetén jellemző a kórkép-re minden stádiumban a nagyfokú gyulladás, a panaszokat kísérő kifejezettebb fájdalom, ritkán észlelhető tünet-mentes állapot, bár az első stádiumban az inokuláció helyén képződő fekély akár az esetek felében észrevétlen maradhat [7]. Differenciáldiagnosztikai lehetőségként a klasszikus kép esetében ulcus molle (chancroid, H. ducreyi), granuloma inguinale (donovanosis, Klebsiella granulomatosis), syphilis, herpes, esetleg gonorrhoea merül-het fel.…”

Clues to uncommon and easily overlooked infectious diagnoses affecting the GI tract and distinction from their clinicopathologic mimics

“…The primary stage occurs after an incubation of 3 to 30 days and presents as a painless, ulcerating papule at the inoculation site, which goes unnoticed by 58% of patients and resolves spontaneously. 26,28 The secondary stage occurs several weeks later and is characterized by painful and typically unilateral inguinal and/or femoral lymphadenopathy. 2,26 Lymphadenopathy is not, however, a sine qua non for LGV.…”