Evidence-based management of Inguinal Swelling (Bubo) according to Uganda Clinical Guidelines 2023

Clinical Features

Excessively swollen inguinal glands. Pain, tenderness. Swellings may become fluctuant if pus forms. Causes: LGV, chancroid, syphilis.

Differential Diagnosis

Leg ulcer, obstructed inguinal hernia.

General

Examine for genital ulcers, rule out leg/buttock infection, exclude hernia. If genital ulcer present, treat as GUD. Otherwise, give doxycycline 100 mg 12 hourly for 14 days and treat partner. Alternative: Azithromycin 1 g single dose.

If partner is pregnant

Give erythromycin 500 mg every 6 hours for 14 days.

Bubo Management

DO NOT incise bubo. Aspirate through normal skin with a large bore needle (gauge <20) every 2 days until resolution.