Inguinal and femoral buboes are localised enlargements of the lymph nodes in the groin area, which are painful and may be fluctuant. They are frequently associated with lymphogranuloma venereum and chancroid. In many cases of chancroid an associated genital ulcer is visible, but occasionally may not be. Non-sexually transmitted local and systemic infections (e.g. infections of the lower limb) can also cause swelling of inguinal lymph nodes.

Recommended syndromic treatment

• ciprofloxacin, 500mg orally, twice daily for 3 days

AND

• doxycycline, 100mg orally twice daily for 14 days

OR

• erythromycin, 500mg orally four times daily for 14 days

Some cases may require longer treatment than the 14 days recommended above. Fluctuant lymph nodes should be aspirated through healthy skin. Incision and drainage or excision of nodes may delay healing and should not be attempted.

FIGURE 4. INGUINAL BUBO