25 years married male c/o multiple ulcers and discharge since 1 week, no history of extramarital contact, no fever but burning micturition. Diagnosis and treatment. His wife 7 months amenorrhea ( pregnancy).

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D/D 1. Genital Herpes simplex. 2.Chancroid 3 Syphilis. 4 . Granuloma inguinale .5.Monilial infection. 6 Early malignancy. Although clinical picture is more in favour of genital herpes. Treatment is 1.Tab Acivir 400 mg T.D.S for 7 days 2.Tab Amoxyclav 625 mg B.D for 7 days

This is a case of Tight Phimosis with severe Balanoposthitis with Ulceratiin of the prepure. Adv : Circumcision to be done to prevent the recurrence of Infection n Catheterisation

He will be diabetic with phimosis ie.obstruction and infection check sugar and do circumcision

Thanks for your respond sir, I ruled out diabetes.first reduce the infection and plan for circumcision.
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'Urogenital trichomoniasis'. Rule out 'leukorrhoea' in his sexual partner.

States of inguinal lymphnodes

Ulcers are painful are not

Phimosis

There is evidence of very tight phimosis with severe balanoposthitis with ulceration of the prepuse. Though there is no history of extramarital exposure in view of thepus discharge venereal diseases and HIV to be ruledout. Control the infection by systemic and local antibiotics hygiene. once the infection is under control dorsal slit to be done to ruleout carcinoma underlying and circumcision to be done to prevent the recurrence of infection.

check for diabetes &jiv. it looks like secondirarly infected herpes or chancroid. antibiotics ceftum BD . mupirocin &ifnoresponce then acyclovir for 10 days 400 mg tdsx.. urine culture.hiv VDRL. pt usually hide ho exposure.pl. reply latter about results

ulceration over tip of prepuce with whitish discharge with swelling showing Balanitis with ?gonorrhoea. history seems concealed.

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