MRCP2-2702

MRCP2-2702

A 30-year-old Indian woman presented to the clinic with a history of a large swelling on her right leg for over four years, accompanied by fever and groin pain. The swelling did not reduce at night. Upon examination, her entire leg was swollen and bluish in color, with a deep skin fold at the junction of the middle and lower third, and a non-discharging sinus above the fold anteriorly. There were no nodules or warts on her limbs.

Hb: 144g/l (130 – 180)
Platelets: 310 * 109/l (150 – 400)
WBC: 9.2 * 109/l (4.0 – 11.0)
Neutrophil: 3.5 * 109/l (1.5 – 7.0)
Lymphocyte: 2.1 * 109/l (1.5 – 4.0)
Eosinophil: 2.4 * 109/l (0.04 – 0.4)
Monocyte: 1.1 * 109/l (0<0.8) What is the drug of choice for the most likely diagnosis in this case?