Lymphogranuloma Venereum (Lgv)

Lymphogranuloma venereum (LGV) is a caused by three identical strains of Chlamydia trachomatis disease that is characterized by small, often asymptomatic skin lesions, followed by regional lymphadenopathy in the bar or in the pool. Alternatively, if acquired through anal sex, it can manifest as severe proctitis. Without treatment, LGV can lead to obstruction of the lymph glands and chronic swelling of the genital tissue. The diagnosis is made by clinical findings, but usually a clinical laboratory confirmation using serological methods or immunofluorescence is possible. The therapy consists of 21 days tetracycline or erythromycin.

LGV is caused by the serotypes L1, L2 and L3 of the bacteria Chlamydia trachomatis. These serotypes are different from those that cause trachoma, an inclusion conjunctivitis, urethritis and cervicitis because they penetrate into regional lymph nodes and multiply.

Lymphogranuloma venereum (LGV) is a caused by three identical strains of Chlamydia trachomatis disease that is characterized by small, often asymptomatic skin lesions, followed by regional lymphadenopathy in the bar or in the pool. Alternatively, if acquired through anal sex, it can manifest as severe proctitis. Without treatment, LGV can lead to obstruction of the lymph glands and chronic swelling of the genital tissue. The diagnosis is made by clinical findings, but usually a clinical laboratory confirmation using serological methods or immunofluorescence is possible. The therapy consists of 21 days tetracycline or erythromycin. LGV is caused by the serotypes L1, L2 and L3 of the bacteria Chlamydia trachomatis. These serotypes are different from those that cause trachoma, an inclusion conjunctivitis, urethritis and cervicitis because they penetrate into regional lymph nodes and multiply. In Germany, the LGV is among men who have sex with men, especially in some metropolitan areas experienced an epidemic spread in recent years. LGV is in the USA only sporadically, but is endemic in parts of Africa, India, Southeast Asia and the Caribbean. It is from the above-mentioned found in men diagnosed much more frequently than women. Symptoms and complaints The first stage begins after an incubation period of about 3 days with a small skin lesion at the entry point. This can cause the overlying skin breaks (ulcerated), but heals so fast that it can pass unnoticed. The second stage usually starts in men after about 2-4 weeks, with inguinal lymph nodes on one or both sides that increase in size and form sometimes very extensive, sensitive, sometimes fluctuating masses (buboes). The buboes adhere to deeper-lying tissue and cause the overlying skin inflamed, sometimes with fever and malaise. In women, it is more common for back pain or pain in the pelvis; the initial lesions may be due to the cervix or vagina of the upper, which leads to an increase inflammation and perirectal and pelvic lymph nodes. There may be multiple draining fistulas form, pus or blood secrete. In the third stage, the lesions heal with scarring, but fistula may persist or recur. Persistent inflammation may occur due to untreated infections and obstruct the lymph vessels and cause swelling and skin wounds. People who practice anal sex, can proctitis or proctocolitis have connected to bloody and purulent rectal effluents possibly during the first stage. During the chronic phase colitis simulating Crohn’s disease, tenesmus and strictures can cause in the rectum or pain due to inflamed lymph nodes in the pelvis. Proctoscopy can diffuse inflammation, polyps and masses or mucopurulent exudate findings are similar to inflammatory bowel disease to be recognized. Diagnostic antibody detection Sometimes Nukleinsäureamplifikationstests (NAAT) The suspected LGV, patients with genital ulcers, swollen inguinal lymph nodes or proctitis, and living in endemic areas, have visited this or had sexual contacts with persons from areas where the infection is common. In men, often a sonographic view of the nearby pelvic inflammatory changes can only recognize the extent of the disease. LGV is suspected in patients with buboes that can be confused with other abscesses bacterial origin. The diagnosis was previously provided by the detection of antibodies against Chlamydia endotoxin (complementary Fixationstiter> 1:64 or microimmunofluorescence titer> 1: 256) or by genotyping by PCR-based NAAT. Antibody levels are usually increased during the occurrence or shortly thereafter and remain so. Meanwhile, direct tests for Chlamydia antigens with immunoassays (z. B. enzyme-linked immunosorbent assay [ELISA]) or by immunofluorescence using monoclonal antibodies that stain pus or NAATs are available and still facilitate the often still difficult diagnosis. All sexual partners should be investigated. After apparently successful treatment, patients should be observed for 6 months. Oral therapy and long-term administration of tetracycline or erythromycin may drainage of bumps for symptom relief. Doxycycline 100 mg p.o. 2 times a day, erythromycin 500 mg po 4 times a day or tetracycline 500 mg po 4 times a day, each for 21 days, are effective in early disease. Azithromycin 1 g p.o. 1 times / week for 1-3 weeks is probably effective, but it was geanuso systematically studied little as clarithromycin. The swelling occurring in later stages of injured tissue may persist despite an elimination of the bacteria. Bubonic can be drained to relief of symptoms with a needle or surgically, but most patients respond rapidly to antibiotics. Bubonic and fistulae may require surgery, but rectal strictures can usually be dilated. Current sexual partner, if infected, treated.

Health Life Media Team

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