Genital Herpes and Swollen Lymph Nodes: STI Differential Diagnosis

Genital lesions with inguinal lymphadenopathy suggest several sexually transmitted infections (STIs).

Differential Diagnosis

Critical Actions

1. Do not self-diagnose. Overlap is common; co-infections occur.
2. Seek STI Clinic/Clinician: Exam, NAAT swabs (HSV, CT/GC, TV), syphilis serology, HIV test.
3. Partner Notification: Essential for all STIs.
4. Treatment: Pathogen-specific (acyclovir/valacyclovir for HSV; penicillin for syphilis; azithromycin/ceftriaxone for chancroid/LGV).

Early diagnosis prevents complications (neonatal herpes, neurosyphilis, infertility) and transmission.

Herpes - Related Articles

• Herpes Seropositivity: Meaning, Testing, and What to Expect
• Herpes Transmission: Understanding the Risks of a 'Kiss' – HSV-1 vs. HSV-2
• Understanding and Preventing Herpes Transmission: A Comprehensive Guide
• Herpes Simplex 1 (HSV-1): Transmission, Symptoms & Prevention
• Sarah Jessica Parker and Eczema: No Public Confirmation
• Genital Herpes & Foreskin: Symptoms, Diagnosis & Treatment
• Understanding and Managing Shingles (Herpes Zoster)

Herpes

• RSV Vaccines for Older Adults: Current Options & Guidance (2024 Update)
• Herpes Encephalitis: Symptoms, Aftereffects & Recovery
• Shingles in Adults: Symptoms, Causes & Treatment
• Living Well with Herpes: Management, Transmission Reduction & Emotional Health
• Herpes in Children: Symptoms, Risks & Prevention
• Equine Herpes Virus (EHV) & Upper Respiratory Tract Disease (URTD) in Horses - Symptoms & Treatment
• Herpes Zoster (Shingles): Symptoms, Causes & Treatment
• MRSA Treatment: 10 Steps from Diagnosis to Recovery
• Understanding and Managing Herpes: Treatment & Prevention
• Herpes Simplex Virus (HSV-1 & HSV-2): Transmission, Clinical Features, and Management
• Herpes Simplex Virus Type 1 (HSV-1): Incubation, Reactivation, and Management
• Heparin-Induced Thrombocytopenia (HIT): Diagnosis and Management

Health Sciences © https://www.222health.com

Infection	Lesion	Lymphadenopathy	Key Features
HSV-2 (Genital Herpes)	Clustered vesicles → painful ulcers	Bilateral, tender, mobile	Recurrent; prodrome; asymptomatic shedding; PCR/swab diagnosis
Syphilis (Secondary)	Maculopapular rash (palms/soles), condyloma lata	Generalized, non-tender, rubbery	RPR/VDRL + confirmatory (TPPA); 2–8w post-chancre
Chancroid (H. ducreyi)	Painful, soft, undermined ulcers (multiple)	Unilateral, suppurative (buboes)	Gram-negative rods; PCR/culture; endemic areas
LGV (C. trachomatis L1–L3)	Transient papule/ulcer → massive buboes	Unilateral, matted, fluctuant, fistulize	Rectal strictures (MSM); NAAT genotyping
Donovanosis (K. granulomatis)	Beefy-red, bleeding granulomas	Inguinal (pseudobuboes)	Tropical; tissue crush prep (Donovan bodies)