Infectious Disease Book

http://www.fpnotebook.com/

Lymphogranuloma venereumAka: LGV

Advertisement

  1. Etiology
    1. Sexually Transmitted Disease with Chlamydia trachomatis
  2. Epidemiology
    1. Previously rare in the United States
    2. Recent outbreaks in U.S.
      1. More common in HIV patients and homosexual men
  3. Symptoms
    1. Fever
    2. Chills
    3. Headache
    4. Meningismus
    5. Anorexia
    6. Arthralgias
    7. Myalgias
  4. Signs
    1. Genital Lesion
      1. Appears 3 days to 3 weeks after exposure
      2. Small painless Vesicle or non-indurated ulcer
    2. Rectal lesion or Proctitis
      1. Women and homosexual men
    3. Inguinal Syndrome
      1. Occurs 2-6 weeks after exposure
      2. Unilateral (66%)
      3. Painful Lymphadenopathy
        1. Inguinal Lymphadenopathy: Groove sign
          1. lymph nodes above and below inguinal ligament
        2. May also involve rectal lymph nodes
      4. May progress to matted nodes and fistulas
  5. Differential Diagnosis
    1. Inflammatory Bowel Disease
  6. Complications
    1. Perirectal Abscess
    2. Perianal Fistula or Stricture
  7. Labs
    1. Complete Blood Count
      1. Leukocytosis
    2. Erythrocyte Sedimentation Rate elevated
    3. Liver Function Tests abnormalities
    4. Culture
      1. Bubo aspirate
      2. Rectal Culture
    5. Serology
      1. CF titer > 1:64
  8. Differential Diagnosis
    1. See Genital Ulcer
  9. Management
    1. Active infection
      1. Doxycycline 100 mg PO bid for 21 days (recommended)
      2. Erythromycin 500 mg PO qid for 21 days
      3. Sulfisoxazole 500 mg PO qid for 21 days
    2. Treat asymptomatic sexual contacts from last month
      1. Doxycycline 100 mg PO bid for 7 days or
      2. Azithromycin 1 gram PO x1 dose

Navigation Tree