Intensive Care Medicine (ICM) Practice Exam

Which microorganism is most likely responsible for a painful genital ulcer with tender inguinal lymphadenopathy?

1. Treponema pallidum

2. Hemophilus ducreyi

3. Human papilloma virus

4. Herpes simplex virus

The correct answer is: Hemophilus ducreyi

The microorganism most likely responsible for a painful genital ulcer with tender inguinal lymphadenopathy is Hemophilus ducreyi. This organism is known to cause chancroid, which presents with painful genital ulcers and typically accompanies swollen, tender inguinal lymph nodes. The hallmark of a chancroid infection is the development of one or more painful ulcers on the genitalia, which can be accompanied by significant suppurative lymphadenopathy. Chancroid is considered a sexually transmitted infection and is particularly prevalent in certain geographic regions. Identification of this condition is crucial because it helps differentiate it from other infections that may cause similar symptoms but have different management and treatment protocols. In contrast, the other microorganisms in the options present different clinical features. Treponema pallidum, responsible for syphilis, typically causes a painless ulcer (primary chancre) and is associated with different systemic manifestations. Human papillomavirus primarily causes asymptomatic lesions or warts, and while it can lead to genital lesions, these are not typically painful and do not present with the acute lymphadenopathy seen in chancroid. Herpes simplex virus can cause painful vesicular lesions or ulcers, but the associated lymphadenopathy is usually non-tender and more generalized, not confined