Match each clinical presentation of a genital ulcer disease with its most appropriate first-line pharmacotherapy.
- A 24-year-old man presents with a single, painless, indurated penile ulcer with a clean base and non-tender bilateral inguinal lymphadenopathy.Intramuscular benzathine penicillin G
- A 21-year-old man presents with multiple painful, deep genital ulcers with a purulent base and tender, unilateral, fluctuant inguinal lymph nodes.Oral azithromycin or intramuscular ceftriaxone
- A 28-year-old man presents with painful, unilateral inguinal lymphadenopathy with a 'groove sign'. He reports having a small painless genital ulcer a few weeks ago that healed spontaneously.Oral doxycycline for 21 days
- A 26-year-old woman presents with multiple small, grouped, severely painful vesicles and shallow ulcers on an erythematous base on her labia.Oral valacyclovir for 7 to 10 days
Cevap
The correct matches align primary syphilis with penicillin, chancroid with azithromycin or ceftriaxone, lymphogranuloma venereum with an extended course of doxycycline, and genital herpes with oral valacyclovir.
Each genital ulcer disease has a distinct clinical phenotype that guides targeted pharmacotherapy. Primary syphilis presents with a painless chancre and is treated with penicillin. Chancroid presents with painful, purulent ulcers and is treated with azithromycin or ceftriaxone. Lymphogranuloma venereum presents with a transient painless ulcer followed by painful buboes and requires 21 days of doxycycline. Genital herpes presents with grouped painful vesicles and is treated with oral antivirals.
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Anahtar Kavram
Diagnosis and management of genital ulcer diseases based on clinical presentation