In , 1 cases of Lymphogranuloma venereum (LGV) were reported in 23 countries. M. Vall-Mayans, I. NoguerBrotes de linfogranuloma venéreo entre hombres homosexuales en Europa, Enferm Infecc Microbiol Clin, 24 (), pp. Request PDF on ResearchGate | Linfogranuloma venéreo: una causa emergente de proctitis en hombres homosexuales en Barcelona | Background and.
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The current standard method for diagnosing LGV is the direct identification of Chlamydia trachomatis in tissue or fluids from the patient.
In addition to the good therapeutic results achieved by systemic medication, surgical excision of the entire lesion quickly led to linfpgranuloma remission patient 1. Related Topics in Sexually Transmitted Disease. Treatment and Outcome Surgical excision of the affected lymph nodes was performed under local anaesthesia.
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Results from contact tracing and public health implications. All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License. Madrid, Spain 3 Department of Microbiology. The lesions ranged from mild and nonspecific hyperemic mucosa case 5, figure 1 to a circumferential ulceration with elevated geographical borders and mucopurulent exudate case 3; figures 2 and 3.
All patients were male, mean age The clinical course of the disease includes three stages. Both genital and extragenital manifestations of the disease can cause serious differential diagnostic difficulties, indirectly leading to progression and dissemination of venero infection.
The initial clinical suspicion linfograniloma of a cutaneous neoplasm Figure 4. Groove sign Large circular lymph nodes buboes above and below inguinal ligament May also involve rectal lymph nodes May progress to matted nodes and fistulas. Search Bing for all related images. Skin biopsy showed lymphocytic infiltrates with some eosinophils Figure 5. The Kappa type paraproteinemia found in this patient could suggest a disorder of the cutaneous microcirculation due to sedimentation of paraproteins combined with thrombocytes, erythrocytes, and fibrinogen in the form of cryoglobulins and cryofibrinogen.
Histopathological examination of the excised cervical lymph nodes was negative for metastatic tumor Figure 3. Serologies for Infectious Diseases. Options choose one Chlamydia trachomatis serotype L1, L2, L3 culture positive Bubo aspirate Rectal lesion culture Immunofluorescence showing Leukocyte s venerso inclusion bodies Inguinal lymph node aspirate Microimmunofluorescence positive Lymphogranuloma venereum strain of Chlamydia trachomatis.
The ulcerative genital form of LGV presented in case 2 is not linfoggranuloma of stage 1b, in which the ulcerations are mainly superficially located and lack fibrous coatings Figure 4. In both cases with more severe mucosal injury cases 3 and 4 distal rectal scarring remained, without stenosis or other complications.
By contrast, in two other patients, one of whom was diagnosed of HIV infection in that linfogranulom, the rectal findings were minimal showing mild mucosa erythema and some aphthas, so the infection could be passed unnoticed. There has been a resurgence of LGV in the last ten years in urban areas of developed countries, particularly among MSM.
The route of inoculation of the microorganism was the anal sexual activity, but the presenting symptoms ranged from mild discomfort to rectal anal suppuration and rectal bleeding, perhaps related to the severity of proctitis or to the time from infection.
Sex Transm Dis ; The role of dermatosurgery as an important supporting method at the initial stages of this disease is evaluated. The personal data in case 1 homosexuality and a recent time spent in Libya provides the clinician important information and enhances the differential diagnosis by raising the possibility of rare and atypical cutaneous manifestations of tropical and subtropical infections, such as LGV.
Differential Diagnosis Inflammatory Bowel Disease. A year-old HIV-negative homosexual man complained of skin problems on his face and enlargement of cervical lymph nodes of three weeks duration Figure 1.
The positive serology with respect to Chlamydia trachomatis and the rapid response to antimicrobial therapy indisputably lead to the interpretation of a rare form of LGV infection. Periodic acid-Schiff and Ziehl-Nielsen stains were negative.
Serology has also been replaced by direct detection tests, but still may have some utility in selected cases e. After a detailed analysis of all the bibliographic sources, we cannot entirely exclude the hypothesis that histopathological findings in LGV-patients can also evolve, in concert with the clinicopathologic findings.
Sexually Transmitted Disease Chapter. It seems that these individuals do not represent a reservoir of the disease.
Lymphogranuloma venereum: “a clinical and histopathological chameleon?”
Rectal lymphogranuloma venereum surveillance in France Case reports We report 5 cases of LGV in white men with proctitis as the initial presentation lesion who were diagnosed between February and February Sex Transm Inf ; Differential Diagnosis See Genital Ulcer.
Up to now, and in our knowledge, there has been no reported case of endoscopic dilation in anal strictures, although it could be an alternative procedure to consider. Search other sites for ‘Lymphogranuloma venereum’.