Seminar on inguinal bubo syndrome.yih

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

3. 3 Swollen glands

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

5. Lymphogranuloma Venereum 3 stages Primary stage(genital ulcer) Secondary satge (lymphadenitis and lymphangitis ) Third stage(fibrosis and edema-genital elephantiasis)

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. Lymphogranuloma Venereum

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. Chancroid (Soft Chancre)

10. Granuloma Inguinale ( Donovanosis ) Essentials of Diagnosis ; chronic ulcerative granulomatous disease that usually develops in the perineum and inguinal regions Donovan bodies revealed by Wright's or Giemsa's 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. Granuloma Inguinale ( Donovanosis )

12. 12 Syphilis Sometimes T. pallidum can be a cause of inguinal lymphadenopthy unlike the other causes, it doesn't generally produce necrosis and abscess collection in the lymph nodes. In conditions where the clinical examination doesn't 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

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

15. 15 complains of inguinal swelling Take history and Examine Inguinal/femoral bubo(s) present? Other STIs Rx LGV, chancroid, GI Educate on RR Provide condoms Partner management Offer HIV testing Advise to return in 7days No Yes Ulcer(s) present? No Yes Use GU flowchart No Educate on RR Offer HCT Condom use Yes Use appropriate flowchart

16. 16 Recommended treatment Ciprofloxacin 500 mg bid orally for 3 days Plus Doxycycline 100mg bid orally for 14 days Or Erythromycin 500 mg po qid for 14 days

17. THANKS