Editor,—Lymphatic filariasis is characterised by a wide range of clinical manifestations. In a non-endemic area the diagnosis may be missed unless the index of suspicion is high.Sex Transm Inf 2000;76:321–328

An 18 year old sexually active male presented with a progressively increasing painless nodular swelling in the right inguinal region of 4 months' duration. The patient had an unprotected vaginal contact with a commercial sex worker 6 months earlier. There was no history of genital ulcer or urethral discharge. The general health …