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Lymphogranuloma venereum: diagnostic and treatment challenges
#MMPMID25870512
Ceovic R
; Gulin SJ
Infect Drug Resist
2015[]; 8
(?): 39-47
PMID25870512
show ga
Lymphogranuloma venereum is a sexually transmitted disease caused by L1, L2, and
L3 serovars of Chlamydia trachomatis. In the last 10 years outbreaks have
appeared in North America, Europe, and Australia in the form of proctitis among
men who have sex with men. Three stages of disease have been described. The
disease in primary stage may go undetected when only a painless papule, pustule,
or ulceration appears. The diagnosis is difficult to establish on clinical
grounds alone and frequently relies upon either serologic testing, culture, or
more recently, nucleic acid amplification testing of direct specimens. A proper
treatment regimen cures the infection and prevents further damage to tissues.
Lymphogranuloma venereum causes potentially severe infections with possibly
irreversible sequels if adequate treatment is not begun promptly. Early and
accurate diagnosis is essential. Doxycycline is the drug of choice. Pregnant and
lactating women should be treated with erythromycin or azithromycin. Patient must
be followed up during the treatment, until disease signs and symptoms have
resolved. Repeated testing for syphilis, hepatitis B and C, and HIV to detect
early infection should be performed.
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