24th September 2020

A 27-year-old male of Middle Eastern origin presents to his GP

A 27-year-old male of Middle Eastern origin presents to his GP with a recent history of unilateral scrotal swelling and pain of a gradual onset over a few days. He has never been in a sexual relationship, has no known medical conditions and is taking no medications. A urine dipstick test is performed, which is normal.  The doctor asks for a first-void urine sample and sends it to be cultured. The results are returned, revealing no bacterial cause of the symptoms. The doctor is convinced the diagnosis is epididymitis and examines the patient again, this time noticing mucosal ulcers on the tongue and a scarred genital ulcer on the scrotum.

The doctor suspects a systemic disease and decides on the next step in management. What is this most likely to be? Select ONE option only.