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Nineteen-year-old man with genital lesions
Margerie & Beverly
Geronimo Rothfeld
RN, RN,
SUBJECTIVE DATA G.F. is a healthy 19-year-old single man who presents in the office with the chief complaint of a “painful bump in my right groin,” which he reports has enlarged over the past 2 weeks. It has caused increasing, moderate, dull pain. The lump was initially noted when he had some groin pain after restarting moderate weight lifting 2 weeks ago. G.F. denies any other symptoms, and his activity and daily routines have been unaffected despite symptoms. Medical history and family history are unremarkable. G.F. reports that he has been sexually active since the age of 16 years. He has had two female sexual partners. He is currently monogamous and reports 100% use of condoms. He has no history of sexually transmitted diseases.
Genifa1Lesions
MSN,CPNP MSN,
CPNP
examination there is a visible, immobile, 5 cm x 3 cm bubo (an inflammatory swelling of lymph nodes) in the right groin. Pain is elicited with palpation, and there is a mild groove sign (lymphadenopathy on both sides of the inguinal ligament that produces an elongated depression). No discharge, ery-
thema, ulcerations, other lesions, or hernias are present. No other lymphadenopathy is noted. The remainder of the physical examination was unremarkable. Gonorrhea culture, Chlamydia culture, Venereal Disease Research Lab (VDRL), and Rapid Plasma Reagen (RI’R) were all negative.
CLINICAL INSIGHTS QUIZ 1. Based on the history and physical examination, what diagnosis do you suspect? 2. What possible d@rential diagnoses would you consider? 3. What further information would be necessary to confirm the diagnosis? 4. What would the recommended treatment befor the actual diagnosis? Answers are on pages 191 and 192.
OBJECTIVE DATA Vital signs are stable. Height and weight are at 50th and 70th percentile, respectively. On physical
July/August
1996
J Pediatr Health Care. (1996). Copyright
10, 183.
0 1996 by the National Association
0891.5245/96/$5.00
of Pediatric
Nurse Associates
& Practitioners.
+ 0 25/8/68872
183
Geronimo Rothfeld
RN, RN,
SUBJECTIVE DATA G.F. is a healthy 19-year-old single man who presents in the office with the chief complaint of a “painful bump in my right groin,” which he reports has enlarged over the past 2 weeks. It has caused increasing, moderate, dull pain. The lump was initially noted when he had some groin pain after restarting moderate weight lifting 2 weeks ago. G.F. denies any other symptoms, and his activity and daily routines have been unaffected despite symptoms. Medical history and family history are unremarkable. G.F. reports that he has been sexually active since the age of 16 years. He has had two female sexual partners. He is currently monogamous and reports 100% use of condoms. He has no history of sexually transmitted diseases.
Genifa1Lesions
MSN,CPNP MSN,
CPNP
examination there is a visible, immobile, 5 cm x 3 cm bubo (an inflammatory swelling of lymph nodes) in the right groin. Pain is elicited with palpation, and there is a mild groove sign (lymphadenopathy on both sides of the inguinal ligament that produces an elongated depression). No discharge, ery-
thema, ulcerations, other lesions, or hernias are present. No other lymphadenopathy is noted. The remainder of the physical examination was unremarkable. Gonorrhea culture, Chlamydia culture, Venereal Disease Research Lab (VDRL), and Rapid Plasma Reagen (RI’R) were all negative.
CLINICAL INSIGHTS QUIZ 1. Based on the history and physical examination, what diagnosis do you suspect? 2. What possible d@rential diagnoses would you consider? 3. What further information would be necessary to confirm the diagnosis? 4. What would the recommended treatment befor the actual diagnosis? Answers are on pages 191 and 192.
OBJECTIVE DATA Vital signs are stable. Height and weight are at 50th and 70th percentile, respectively. On physical
July/August
1996
J Pediatr Health Care. (1996). Copyright
10, 183.
0 1996 by the National Association
0891.5245/96/$5.00
of Pediatric
Nurse Associates
& Practitioners.
+ 0 25/8/68872
183