A 45-year-old man comes to the office with groin pain and swelling. About a month ago, he noticed a sore on his penis but did not seek medical attention because the ulcer was not painful and disappeared within a week. Several days ago, he began to experience painful swelling in his inguinal region, with inflammation of the overlying skin and eventual formation of several draining ulcers. He also has mild fever and malaise that began around the same time as his groin symptoms. The patient is a sailor. His other medical problems include well-controlled hypertension and hyperlipidemia. Cell scrapings from his lesions show cytoplasmic inclusion bodies. Which of the following is the most likely cause of this patient's condition?

Question

A 45-year-old man comes to the office with groin pain and swelling.  About a month ago, he noticed a sore on his penis but did not seek medical attention because the ulcer was not painful and disappeared within a week.  Several days ago, he began to experience painful swelling in his inguinal region, with inflammation of the overlying skin and eventual formation of several draining ulcers.  He also has mild fever and malaise that began around the same time as his groin symptoms.  The patient is a sailor.  His other medical problems include well-controlled hypertension and hyperlipidemia.  Cell scrapings from his lesions show cytoplasmic inclusion bodies.  Which of the following is the most likely cause of this patient's condition?

Quizplus · Accepted Answer

Eductional Objective: Chlamydia trachomatis serotypes L1 through L3 cause lymphogranuloma venereum, a sexually transmitted disease characterized initially by painless ulcers with later progression to painful inguinal lymphadenopathy ("buboes") and ulceration.  Chlamydial inclusion bodies are seen in host cell cytoplasm.

A 45-Year-Old Man Comes to the Office with Groin Pain