n South African Medical Journal - Care report - Syphilitic lymphadenitis clinically and histologically mimicking lymphogranuloma venereum : in practice




An inguinal lymph node was discovered incidentally during surgery for a suspected strangulated inguinal hernia. The patient had recently been treated for candidal balanoposthitis and was known to have a paraphimosis. A new foreskin ulcer was discovered when he was admitted for the hernia surgery. The lymph node histology showed stellate abscesses suggestive of lymphogranuloma venereum (LGV). Chlamydial serologic tests were negative. As the histological appearance and clinical details provided were thought to suggest LGV, tissue was also sent for a real-time quadriplex polymerase chain reaction assay. This was used to screen for in conjunction with other genital ulcer-related pathogens. The assay was negative for , but positive for . Further histochemical staining of the histological specimen confirmed the presence of spirochaetes.


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