C. Viravan et al., A PROSPECTIVE CLINICAL AND BACTERIOLOGICAL STUDY OF INGUINAL BUBOES IN THAI MEN, Clinical infectious diseases, 22(2), 1996, pp. 233-239
One-hundred thirteen men (mean age, 23 years) who presented with ingui
nal buboes to a government-operated hospital for sexually transmitted
diseases (STDs) in Bangkok were studied between February 1987 and Febr
uary 1989, The median duration of preceding symptoms was 7 days (range
, 1-62 days), The majority of patients (74; 65%) had received treatmen
t previously; 31 (27%) were febrile, 13 (12%) had extrainguinal lympha
denopathy, and 31 (27%) had concurrent active genital ulcers, There wa
s no history of genital ulceration in 66 (58%) of the patients, Pus wa
s obtained from 51 of the 110 buboes aspirated for culture; 21 (41%) o
f these cultures yielded Haemophilus ducreyi, and 2 (3.9%) were positi
ve for Chlamydia trachomatis on immunofluorescence microscopy, Saline
(1 mt) was injected and reaspirated from the buboes of 35 of the other
59 patients; 3 buboes yielded H. ducreyi and 9 were positive for C. t
rachomatis. All cultures for other aerobic and anaerobic bacteria and
viruses in intact buboes were negative, Syphilis serology was positive
in only one case, Patients attending STD clinics in this region who h
ave large, fluctuant, edematous inguinal buboes containing pus should
receive presumptive treatment for chancroid, If there is no pus, then
the bubo is more likely to be caused by lymphogranuloma venereum.