Question:
A patient presents with painful grouped vesicles over the penile/genital region associated with fever and malaise. What is the most likely causative organism?
A patient presents with painful grouped vesicles over the penile/genital region associated with fever and malaise. What is the most likely causative organism?
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Painful grouped genital vesicles + systemic symptoms = herpes.
Updated On: Jun 25, 2026
- Herpes simplex virus (HSV)
- Haemophilus ducreyi
- Human papillomavirus (HPV)
- Treponema pallidum (Syphilis)
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The Correct Option is A
Solution and Explanation
Step 1: Identify the lesion morphology.
The combination of painful, grouped vesicles on an erythematous base over the genitalia, with systemic features (fever, malaise), is the classic picture of primary genital herpes caused by herpes simplex virus (usually HSV-2).
Step 2: Match to the organism.
Primary HSV infection characteristically produces multiple painful vesicles that rupture into shallow ulcers, accompanied by tender inguinal lymphadenopathy and constitutional symptoms - exactly as described.
Step 3: Why the other options are wrong.
Haemophilus ducreyi causes chancroid - painful, ragged, undermined ulcers, not vesicles, and usually without prominent systemic vesicular eruption. HPV causes painless warts (condylomata acuminata), not painful vesicles. Treponema pallidum (syphilis) causes a painless, indurated chancre with painless adenopathy - the opposite of this painful vesicular presentation.
Key fact: Painful grouped genital vesicles with fever and malaise = primary genital herpes (HSV).
The combination of painful, grouped vesicles on an erythematous base over the genitalia, with systemic features (fever, malaise), is the classic picture of primary genital herpes caused by herpes simplex virus (usually HSV-2).
Step 2: Match to the organism.
Primary HSV infection characteristically produces multiple painful vesicles that rupture into shallow ulcers, accompanied by tender inguinal lymphadenopathy and constitutional symptoms - exactly as described.
Step 3: Why the other options are wrong.
Haemophilus ducreyi causes chancroid - painful, ragged, undermined ulcers, not vesicles, and usually without prominent systemic vesicular eruption. HPV causes painless warts (condylomata acuminata), not painful vesicles. Treponema pallidum (syphilis) causes a painless, indurated chancre with painless adenopathy - the opposite of this painful vesicular presentation.
Key fact: Painful grouped genital vesicles with fever and malaise = primary genital herpes (HSV).
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