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A previously healthy male teenager presented with a 2-week history of tender swelling in the right groin, not responding to 7 days of amoxicillin-clavulanate. There was no history of recent sexual activity. He could not recall any trauma, insect or tick bites during frequent mountain biking in a local forest in Switzerland. Examination revealed a painful unilateral inguinal lymphadenopathy (figure 1), corresponding to a hyperechoic lymph node in ultrasonography (3×2×6 cm). Genital examination was unremarkable, …
Contributors PMMS, MS and CB: patient care and/or diagnostic workup; critically reviewed the manuscript. PMMS: drafting the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.