Etiology Lymphogranuloma venereum...

Etiology

Lymphogranuloma venereum (LGV) is caused according to Chlamydia trachomatis serovars L1 to L3 (C trachomatis serovars B and D-K are responsible for the syndrome of non-gonococcal urethritis and cervicitis.)

Clinical manifestations

The primary lesion produc according to LGV is a small, non-painful genital papule, which can ulcerate at the site of inoculation after an incubation period of three to 30 days. This lesion can remain undetect within the urethra, vaginal vault, or rectum

public clinical manifestations include (1) infantile unilateral, or bilateral inguinal and/or femoral adenopathy, which can become fluctuant; and (2) hemorrhagic proctitis or proctocolitis, which is associated with receptive anal intercourse. The clinical and histologic presentation of LGV proctocolitis can be similar to the initial manifestations of inflammatory bowel disease.

Diagnosis

Diagnosis is based primarily onward clinical findings; routine laboratory confirmation might not be possible.

Serologic touchstones for C. trachomatis (i.e., microimmuno-fluorescence or completeness fixation) can support diagnosis.

Direct identification of C trachomatis from a lesion (i.e., bubo) or site of the infection (eg rectum) can be made by means of using culture or by using nonculture nucleic acid testing; however, neither [i]modus operandi[/i] is specific for LGV, and use of rectal swabs for nucleic acid testing is not cleared from the U.S. Food and unsalable article Administration.

Treatment

The attract favor toed treatment is administration of 10 mg of doxycycline, twice daily for 21 days. Alternative treatment is 500 mg of erythromycin base orally, four times a day for 21 days. about subspecialists believe 1 g of azithromycin, administered orally formerly weekly for three weeks, is effective; however, clinical data are lacking.

Sex partners who had contact with the patient within 30 days of the patient's attack of symptoms should be evaluated; in the absence of symptoms, they should be treated with either 1 g of azithromycin in a single dose, or 100 mg of doxycycline, twice a day for seven days.

COPYRIGHT 2005 American Academy of Family Physicians

COPYRIGHT 2005 Gale Group