Question

A 30-year-old man presents with a painless genital ulcer and generalised non-tender lymphadenopathy. He had unprotected sex with multiple partners. What is the most appropriate initial diagnostic test?

Accepted Answer

Rapid plasma reagin (RPR) or VDRL plus treponemal-specific serology

Answer

Gram stain and culture of the ulcer

Answer

Dark-field microscopy of exudate from the lesion

Answer

HSV PCR only

Answer

Biopsy of the ulcer

Practice question

A 30-year-old man presents with a painless genital ulcer and generalised non-tender lymphadenopathy. He had unprotected sex with multiple partners. What is the most appropriate initial diagnostic test?