Lymphogranuloma venereum - Revision history

Aidan at 16:35, 3 December 2020

2020-12-03T16:35:10Z

← Older revision		Revision as of 16:35, 3 December 2020
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	*Occasionally involves arthritis, pneumonitis, hepatitis, and rarely involves carditis, aseptic meningitis, or ocular inflammation		*Occasionally involves arthritis, pneumonitis, hepatitis, and rarely involves carditis, aseptic meningitis, or ocular inflammation

	====Secondary LGV ~~with~~ ~~lymphadenopathy~~====		====Secondary LGV With Lymphadenopathy====

	*Most commonly involves painful inguinal or femoral lymphadenopathy, called "buboes"		*Most commonly involves painful inguinal or femoral lymphadenopathy, called "buboes"
	*The "groove sign", where nodes are seen above and below the inguinal ligament, is highly specific for LGV		*The "groove sign", where nodes are seen above and below the inguinal ligament, is highly specific for LGV

	====Secondary LGV ~~with~~ ~~anorectal~~ ~~symptoms~~====		====Secondary LGV With Anorectal Symptoms====

	*Presents with acute hemorrhagic proctitis		*Presents with acute hemorrhagic proctitis

Aidan: /* Clinical Manifestations */

2020-08-05T13:55:41Z

Clinical Manifestations

← Older revision		Revision as of 13:55, 5 August 2020
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	===Primary LGV===		===Primary LGV===

	*Incubation period 3 to 30 days		*Incubation period [[Usual incubation period::3 to 30 days]]
	*Starts with small painless papule at site of inoculation that may ulcerate		*Starts with small painless papule at site of inoculation that may ulcerate
	*Only noticed in 50% of patients		*Only noticed in 50% of patients

Aidan: /* Management */

2020-07-30T18:13:21Z

Management

← Older revision		Revision as of 18:13, 30 July 2020
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	*Do not treat with excision or incision and drainage		*Do not treat with excision or incision and drainage
			*Antibiotics
⚫	*~~First-line:~~ [[Is ~~treated~~ ~~by::~~doxycycline]] 100 mg PO bid for 21 days
	*~~Alternative~~: [[Is treated by::~~erythromycin~~]] ~~500~~ mg PO ~~qid~~ for 21 days		**First-line: [[Is treated by::doxycycline]] 100 mg PO bid for 21 days
	*Alternative: [[Is treated by::~~azithromycin~~]] 1 g PO ~~weekly~~ for 3 ~~weeks~~		**Alternative: [[Is treated by::erythromycin]] 500 mg PO qid for 21 days
			**Alternative: [[Is treated by::azithromycin]] 1 g PO weekly for 3 weeks
	*Perform a test-of-cure at 3 to 4 weeks following completion of treatment		*Perform a test-of-cure at 3 to 4 weeks following completion of treatment
	*Also treat any sexual partners within the last 60 days		*Also treat any sexual partners within the last 60 days
		⚫	**[[Azithromycin]] 1 g PO once or [[doxycycline]] 100 mg PO bid for 7 days
	*Also rule out other concurrent sexually-transmitted infections, including [[chancroid]] and [[donovanosis]]		*Also rule out other concurrent sexually-transmitted infections, including [[chancroid]] and [[donovanosis]]

Aidan: /* Management */

2020-07-30T18:12:24Z

Management

← Older revision		Revision as of 18:12, 30 July 2020
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	**Aspirate through healthy skin		**Aspirate through healthy skin

	== Diagnosis ==		==Diagnosis==

	* Typically done by diagnosing [[Chlamydia trachomatis]] and then confirming the serotype with the reference laboratory		*Typically done by diagnosing [[Chlamydia trachomatis]] and then confirming the serotype with the reference laboratory
	* Sample should be taken from swab of lesion (if primary), or bubo aspirate, swab of rectum, vagina, oropharynx, or urethra, or urine (if secondary or tertiary)		*Sample should be taken from swab of lesion (if primary), or bubo aspirate, swab of rectum, vagina, oropharynx, or urethra, or urine (if secondary or tertiary)
	* Chlamydia testing with culture or NAAT		*Chlamydia testing with culture or NAAT
	* Confirmatory testing with DNA sequencing or RFLP at a reference laboratory		*Confirmatory testing with DNA sequencing or RFLP at a reference laboratory

	== Management ==		==Management==

	* Do not treat with excision or incision and drainage		*Do not treat with excision or incision and drainage
	* First-line: [[Is treated by::doxycycline]] 100 mg PO bid for 21 days		*First-line: [[Is treated by::doxycycline]] 100 mg PO bid for 21 days
	* Alternative: [[Is treated by::erythromycin]] 500 mg PO qid for 21 days		*Alternative: [[Is treated by::erythromycin]] 500 mg PO qid for 21 days
	* Alternative: [[Is treated by::azithromycin]] 1 g PO weekly for 3 weeks		*Alternative: [[Is treated by::azithromycin]] 1 g PO weekly for 3 weeks
			*Perform a test-of-cure at 3 to 4 weeks following completion of treatment
	* Also treat any sexual partners within the last 60 days		*Also treat any sexual partners within the last 60 days
	* Also rule out other concurrent sexually-transmitted infections, including [[chancroid]] and [[donovanosis]]		*Also rule out other concurrent sexually-transmitted infections, including [[chancroid]] and [[donovanosis]]

	==Prevention==		==Prevention==

Aidan at 18:09, 30 July 2020

2020-07-30T18:09:00Z

Show changes

Aidan: /* Background */

2020-07-30T17:54:04Z

Background

← Older revision		Revision as of 17:54, 30 July 2020
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	== Background ==		== Background ==
	* Infection caused by [[Chlamydia trachomatis]] serovars L!, L2 and L3		* Infection caused by [[Chlamydia trachomatis]] serovars L1, L2 and L3
	* Transmitted sexually through vaginal, anal, or oral contact		* Transmitted sexually through vaginal, anal, or oral contact

Aidan: Created page with "== Background == * Infection caused by Chlamydia trachomatis serovars L!, L2 and L3 * Transmitted sexually through vaginal, anal, or oral contact === Epidemiology === * U..."

2020-07-30T17:53:53Z

Created page with "== Background == * Infection caused by Chlamydia trachomatis serovars L!, L2 and L3 * Transmitted sexually through vaginal, anal, or oral contact === Epidemiology === * U..."

New page

== Background ==
* Infection caused by [[Chlamydia trachomatis]] serovars L!, L2 and L3
* Transmitted sexually through vaginal, anal, or oral contact

=== Epidemiology ===
* Uncommon in Canada but more common in parts of Africa, Asia, South America, and the Caribbean
* Occasional outbreaks among men who have sex with men

== Clinical Manifestations ==
=== Primary LGV ===
* Incubation period 3 to 30 days
* Starts with small painless papule at site of inoculation that may ulcerate
* Only noticed in 50% of patients

=== Secondary LGV ===
* Latency of 2 to 6 weeks from primary lesion
* Presents with systemic symptoms, including fevers and chills, malaise, myalgias, and arthralgias
* May have abscess with or without draining sinuses
* Occasionally involves arthritis, pneumonitis, hepatitis, and rarely involves carditis, aseptic meningitis, or ocular inflammation

==== Secondary LGV with lymphadenopathy ====
* Most commonly involves painful inguinal or femoral lymphadenopathy, called "buboes"
* The "groove sign", where nodes are seen above and below the inguinal ligament, is highly specific for LGV

==== Secondary LGV with anorectal symptoms ====
* Presents with acute hemorrhagic proctitis
* May also cause constipation

=== Tertiary LGV ===
* Also called chronic LGV, and occurs in 10 to 20% of untreated patients
* Characterized by chronic inflammation that causes:
** Lymphadtic obstruction leading to genital elephantiasis
** Genital and rectal strictures and fistulae
* Can cause esthiomene, extensive destruction of genitalia

== Investigations ==
* Anoscopy/sigmoidoscopy/proctoscopy
** Similar appearance to ulcerative colitis
* Bubo aspiration
** Usually contains small amount of milky fluid
** Aspirate through healthy skin

== Prevention ==
* Consistent use of condoms or other barrier methods, including for oral sex
* Avoid mucosal trauma if possible

[[Category:Sexually-transmitted infections]]
[[Category:Infectious diseases]]