A patient presents with painless groins swelling. Examination reveals matted inguinal lymph nodes with 'groove sign' (groove between inguinal and femoral groups of nodes). The most likely diagnosis and responsible organism are:
- A Chancroid; Haemophilus ducreyi
- B Lymphogranuloma venereum; Chlamydia trachomatis L1, L2, L3 serovars ✓
- C Donovanosis; Klebsiella granulomatis
- D Secondary syphilis; Treponema pallidum
Explanation
Lymphogranuloma venereum (LGV) is caused by Chlamydia trachomatis serovars L1, L2, and L3 (which are more invasive than serovars causing urethritis). The groove sign (Greenblatt's sign) — a pathognomonic feature — results from inguinal bubo being divided by the inguinal ligament into upper (inguinal) and lower (femoral) groups creating a groove. The primary lesion is a transient painless papule/ulcer often missed. Treatment is doxycycline 100 mg BD for 21 days. Chancroid causes painful, tender inguinal nodes (bubo) without groove sign. Donovanosis causes painless progressive ulceration without true lymphadenopathy.
Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.