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Case of the Month - March 2012

Frans Radebe NICD/NHLS

A 50-year old man from Mozambique presented with a painless penile ulcer with bilateral, tender, matted inguinal lymphadenopathy that had not ruptured. His testes were normal and there was no visible urethral discharge. Genital samples were collected from the ulcer and urethra for Chlamydia culture and blood taken for syphilis and HIV serology.

Genital swab and urethral cultures were positive for Chlamydia trachomatis and Chlamydia trachomatis IgG titre of 1:256 was observed. Syphilis serology was positive at a titre of 1:2 for RPR. He was treated with doxycycline 100mg twice a day for 21 days HIV ELISA was negative. Bubo pus was aspirated from the patient post-treatment, which was negative for Chlamydia on culture. In line with syndromic management of genital ulcer syndrome, he was treated with Benzathine Penicillin for syphilis

Question 1: Discuss the aetiology and pathogenesis of LGV.

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