The differential diagnosis in anogenital ulcer-adenopathy syndrome in men who have sex with men (MSM) is becoming more complex, particularly with lymphogranuloma venereum and syphilis re-establishing endemicity among MSM. Sexual contact has been shown to transmit methicillin-resistant Staphylococcus aureus (MRSA), probably through intimate skin-to-skin contact. We present a case of MRSA genital ulceration and local lymphadenopathy in a man whose sexual partners are men, reporting high-risk sexual behaviour, highlighting the importance of also considering MRSA infection in these cases, and the potential for spread of MRSA infection in the MSM community.
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