A 30-year-old man with lymphogranuloma venereum confirmed by serology has fluctuant inguinal buboes. Which antibiotic course is recommended?

• A Cotrimoxazole double strength twice daily for 3 days
• B Doxycycline 100 mg twice daily for 7 days
• C Penicillin V 500 mg four times daily for 14 days
• D Doxycycline 100 mg twice daily for 21 days ✓

Explanation

Chlamydia trachomatis L1, L2, and L3 serovars require prolonged therapy; doxycycline 100 mg twice daily for 21 days is the preferred regimen, with erythromycin as the alternative. Short courses fail because the organism persists within draining lymph nodes, and penicillins have no activity against chlamydiae.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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