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Seminar on inguinal bubo syndrome.yih


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Seminar on inguinal bubo syndrome.yih

  1. 1. Seminar on inguinal bubo syndrome By Yihienew Mequanint (clinical II student) Adama science and technology university Asella, Arsi, Ethiopia 1,13,2004E.C
  2. 2. Inguinal Bubo syndrome 2
  3. 3. Swollen glands 3
  4. 4. Inguinal Bubo• Swelling of inguinal lymph nodes as a result of STIs• a painful, often fluctuant, swelling of the lymph nodes in the inguinal region (groin)• The common sexually transmitted pathogens that are associated with inguinal bubo include – C. trachomatis (serovar L1, L2 and L3): LGV: – H. ducreyi: Chancroid – K.Granulomatis (Calymmatobacterium granulomatis): Granuloma ingunale – T.pallidum: syphilis• Rarely systemic symptoms except LGV 4
  5. 5. Lymphogranuloma Venereum• 3 stages – Primary stage(genital ulcer) – Secondary satge(lymphadenitis and lymphangitis) – Third stage(fibrosis and edema-genital elephantiasis)
  6. 6. Lymphogranuloma Venereum• Early in the course of the disease, a vesicopustular eruption may go undetected. This transient, primary, painless genital or anorectal ulcer develops after 2-5 days.• Multiple, large, confluent inguinal nodes develop 2 to 3 weeks later and eventually suppurate. Acute infection may cause generalized systemic symptoms• With inguinal (and genital) ulceration, lymphedema, and secondary bilateral invasion, excruciating conditions arise. Sitting or walking may cause pain• During the inguinal bubo phase, the groin is exquisitely tender• LGV responds to 3-week regimens of doxycycline or erythromycin in the usual doses
  7. 7. Lymphogranuloma Venereum
  8. 8. Chancroid (Soft Chancre)• suppurative inguinal adenopathy with painful ulcers is pathognomonic• Culture positive for H ducreyi• The early chancroid lesion is a vesicopustule• Later, it degenerates into a saucer-shaped ragged ulcer circumscribed by an inflammatory wheal• Typically, the lesion is very tender and produces a heavy, foul discharge that is contagious
  9. 9. Chancroid (Soft Chancre)
  10. 10. Granuloma Inguinale (Donovanosis)• Essentials of Diagnosis; – chronic ulcerative granulomatous disease that usually develops in the perineum and inguinal regions – Donovan bodies revealed by Wrights or Giemsas stain a painless, "beefy-red ulcer" with a characteristic rolled edge of granulation tissue. The painless genital ulcers can be mistaken for syphilis.  In contrast to syphilitic genital ulcers, inguinal lymphadenopathy is generally absent
  11. 11. Granuloma Inguinale (Donovanosis)
  12. 12. Syphilis• Sometimes T. pallidum can be a cause of inguinal lymphadenopthy – unlike the other causes, it doesnt generally produce necrosis and abscess collection in the lymph nodes. – In conditions where the clinical examination doesnt reveal a fluctuant bubo, syphilis should be additionally considered and treated accordingly – Surgical incisions are contraindicated and the pus should only be aspirated using a hypodermic needle – NB hard chancre is painless, non-exudative, hard (indurated) edge, unlike soft chancre 12
  13. 13. Syphilis
  14. 14. Inguinal Bubo Flow Chart• Men affected more than females• Common predisposing factor for the spread of HIV• Complications: – Abscess formation and PID – Lymphatic obstruction – Stenosis and Infertility 14
  15. 15. complains of inguinal swelling Take history and Examine Educate on RR Inguinal/femoral No No Offer HCT Other bubo(s) present? STIs Condom use Yes Yes Ulcer(s) present? Yes Use appropriate flowchart NoRx LGV, chancroid, GI•Educate on RR Use GU•Provide condoms flowchart•Partner management•Offer HIV testing 15•Advise to return in 7days
  16. 16. Recommended treatmentCiprofloxacin 500 mg bid orally for 3 days PlusDoxycycline 100mg bid orally for 14 days Or Erythromycin 500 mg po qid for 14 days 16
  17. 17. THANKS