[Lymphogranuloma venerum as ulcerous proctitis in men who have sex with men].
Olafiaklinikken, 0154 Oslo. email@example.com
Lymphogranuloma venerum (LGV), previously lymphogranulma inguinale, is a sexually transmitted infection caused by Chlamydia trachomatis serovar L1-L3. The disease is primarily manifested by a small papule or erosion in the genital region, followed by lymphadenitis and development of abscesses. Proctitis and systemic disease may occur subsequently. LGV has been a rare condition in the western world, but there have been frequent reports from larger cities in Europe and the USA from 2004. Outbreaks have been limited to networks of gay men practising mano-brachial sex (“fisting”). The syndrome may easily be confused with chronic diseases of the gut, bacterial infections and other sexually acquired diseases. We present two HIV-positive gay men where lymphogranuloma venerum was found to be the cause of ulcerative proctitis. The diagnosis was confirmed by a positive Chlamydia test from the anus with subsequent subtyping.
Re-emergence of lymphogranuloma venereum.
Lymphogranuloma venereum (LGV) is a sexually transmitted infection caused by the L1, L2 and L3 serotypes of Chlamydia trachomatis. The disease has been in the spotlight recently because of recent outbreaks in Europe as well as the USA. A unique feature of the recent outbreaks has been that most cases have been caused by the L2 strain. Another unique feature of these outbreaks is the fact that most cases have occurred in men having sex with men, and most patients have presented with proctitis. Interestingly, most recent cases have occurred in human immunodeficiency virus-seropositive patients. Usually, the disease is divided into three phases: the primary stage characterized by a self-healing papule, the secondary stage characterized by proctitis or lymphadenopathy and the tertiary stage characterized by lymphedema and anal strictures. Tests used for diagnosis include polymerase chain reactions and compliment fixation tests. The treatment of choice is doxycycline.