| Author | 14 Posts |
Perhaps
Forum Elite
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A sexually active 20-year-old woman has had fever, chills, malaise, and pain of the vulva for 2 days. Examination shows a vulvar pustule that has ulcerated and formed multiple satellite lesions. Nodes are palpated in the inguinal and femoral areas. A smear of fluid from the lesions establishes the diagnosis. Which of the following is the most likely causal organism?
A) Chlamydia trachomatis
B) Haemophilus ducreyi
C) Neisseria gonorrhoeae
D) Streptococcus pyogenes (group A)
E) Treponema pallidum
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| shumaila
Forum Elite
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A>>?????
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| frank100
Forum Guru
Topics: 48
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pretty confusing. but A. supported by epidemiology and some clinical features. but i´m not so sure about that one
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| HighHopes
Forum Senior
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Lymphogranuloma venereum , A
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| drk1980
Forum Guru
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B. buboes are seen in chancroid as well. But to diagnose LGV u'd need to aspirate from LN. Whereas in chancroid a "smear" shd be possible....revealing gram neg coccobacilli 'school of fish'?
but the clincher is tht LGV is typically painless, whereas this girl has pain of the vulva.
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| juanma0
Forum Senior
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I agree, B is the answer for already explained reasons.
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| anjushree
Forum Guru
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in chancroid,genital lesion &adenitis occur at same time
in LGVgenital lesion ----a gap of1-4 wks &then buboes
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| Guptashutosh
Forum Elite
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agree with B) H. ducreyi
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| chemamr
Moderator and PGY2
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B
and A is a good differential
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| coolmavs
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Good discussion!
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| MAGY17
Forum Elite
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yes is b
dx is chancroid caused by haemophilus ducreyi
why not chlamydia, because the case had pustule and chlamydia the classic finding is mucopurulent cervical discharge
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| liliaeliz
Forum Elite
Topics: 38
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B pustule----ulcrs ,painfull, adenophaty
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| liliaeliz
Forum Elite
Topics: 38
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LGv papule--beefy red ulcers painless
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| SkiKidd
Forum Newbie
Topics: 0
Posts: 21
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Although candida is the traditional lesion with satelitte growth H. ducreyi, HSV and even HPV can have what is described as satellite lesions. B, C & D are the only options that could be diagnosed purely by smear. S pyogenes can also cause satellite lesions but rarely causes ulcers and isnt traditionally a vulvar infection.
I'd say H. ducreyi
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