Infectious Disease Book

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Lymphogranuloma venereumAka: LGV

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  1. Etiology
    1. Sexually Transmitted Disease
    2. Caused by Chlamydia trachomatis subtypes L1, L2, L3
  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. General
      1. Fever and chills
      2. Headache or meningismus
      3. Anorexia
      4. Arthralgias and Myalgias
    2. Proctocolitis if rectal exposure
      1. Mucus or bloody discharge from anus
      2. Anal Pain
      3. Constipation
      4. Tenesmus
  4. Signs
    1. Genital Lesion
      1. Appears 3 days to 3 weeks after exposure
      2. Starts as nontender Papule
      3. Develops small painless Vesicle or non-indurated ulcer at site within 3 to 30 days
    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
  10. References
    1. (2004) MMWR Morb Mortal Wkly Rep 53(42):985
    2. Workowski (2006) MMWR Recomm Rep 55:1

Lymphogranuloma Venereum (C0024286)

Definition (MSH)Subacute inflammation of the inguinal lymph glands caused by certain immunotypes of CHLAMYDIA TRACHOMATIS. It is a sexually transmitted disease in the U.S. but is more widespread in developing countries. It is distinguished from granuloma venereum (see GRANULOMA INGUINALE), which is caused by Calymmatobacterium granulomatis.
Definition (CSP)subacute inflammation of the inguinal lymph glands caused by certain immunotypes of Chlamydia trachomatis; a sexually transmitted disease in the United States but is more widespread in developing countries; do not confuse with granuloma venereum, which is caused by Calymmatobacterium granulomatis, for this use ENTEROBACTERIACEAE DISEASE.
ConceptsDisease or Syndrome (T047)
ICD9099.1, 099.1
MSHD008219
EnglishClimatic AND/OR tropical bubo, Climatic or tropical bubo, DURAND-NICOLAS-FAVRE DISEASE, FAVRE-DURAND DISEASE, FREI DISEASE, LGV - Lymphogranuloma venereum, Lymphogranuloma Inguinale, Lymphogranuloma Venereum, LYMPHOPATHIA VENEREUM, Nicholas Favre disease, Nicolas-Favre disease
Spanishbubon climatico o tropical, bubon climatico Y/O tropical, enfermedad de Durand - Nicolas - Favre, enfermedad de Nicholas Favre, enfermedad de Nicolas - Favre, LGV - Linfogranuloma venereo, linfogranuloma inguinal, linfogranuloma venereo
Parent ConceptsChlamydia Infections (C0008149), Sexually Transmitted Diseases (C0036916), Other venereal diseases (C0153229), Communicable Diseases (C0009450), Chlamydial dermatological disorders (C0458380), Disorder of soft tissue of trunk (C0459151), Chlamydia trachomatis infection (C0518948), Ambiguous concept (C1274012), Disorder of skin AND/OR subcutaneous tissue of trunk (C1290026), Disorder of pelvis (C1290866)
SourcesCOSTAR, CSP, DXP, ICD9CM, LCH, MSH, MTHICD9, NCI, NDFRT, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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