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Intravital Microscopy of the Inguinal Lymph Node
07:34

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Published on: April 4, 2011

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Man with bilateral inguinal lymphadenopathy.

Charlotte Delcourt1, Jean Cyr Yombi1, Halil Yildiz1

  • 1Department of Internal Medicine and Infectiology, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium.

Emergency Medicine Journal : EMJ
|July 22, 2018
PubMed
Summary

A man with inguinal swelling and a penile ulcer had a possible sexually transmitted infection. Further tests are needed to differentiate between Lymphogranuloma venereum and other conditions like syphilis or tuberculosis.

Keywords:
infectioninfectious diseases, bacterialtreatment

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Area of Science:

  • Infectious Diseases
  • Clinical Medicine
  • Dermatology

Background:

  • A 37-year-old male presented with a two-week history of bilateral inguinal swelling, night sweats, and a penile ulcer.
  • The patient had a history of lymph node tuberculosis and recent extraconjugal sexual contact.
  • He owned a cat but reported no history of scratches.

Observation:

  • Physical examination revealed significant bilateral inguinal adenopathy (5 cm), characterized by tenderness, erythema, and pain.
  • A small ulceration was noted at the base of the penis.
  • Vital signs were within normal limits during the examination.

Findings:

  • The differential diagnosis for these symptoms includes Lymphogranuloma venereum (LGV), syphilis, tuberculosis, cat-scratch disease, and toxoplasmosis.
  • The combination of inguinal adenopathy and genital ulceration points towards a sexually transmitted infection, with LGV being a strong consideration.
  • Further diagnostic workup is essential to confirm the etiology.

Implications:

  • Accurate diagnosis is crucial for appropriate treatment and to prevent complications associated with these infections.
  • Understanding the clinical presentation aids in differentiating between various infectious etiologies presenting with similar symptoms.
  • This case highlights the importance of considering a broad range of differential diagnoses in patients with genital ulcers and lymphadenopathy.