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[Lymphogranuloma venereum. Two cases from Dresden]
P Spornraft-Ragaller1, C Lück, E Straube
1Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstrasse 74, 01307 Dresden. Petra.Spornraft-Ragaller@mailbox.tu-dresden.de
Summary
Lymphogranuloma venereum (LGV), a rare sexually transmitted infection, is increasing among men who have sex with men (MSM). Early diagnosis and doxycycline treatment are effective for this Chlamydia trachomatis infection.
Area of Science:
- Infectious Diseases
- Public Health
- Genitourinary Medicine
Background:
- Lymphogranuloma venereum (LGV), caused by Chlamydia trachomatis serovars L1-3, was historically rare in Western countries.
- Recent outbreaks of LGV and LGV proctitis have been reported among men who have sex with men (MSM) in Europe.
Observation:
- Two cases of HIV-1 infected MSM in Dresden, Germany, presented with genital ulcers, inguinal lymphadenitis, or ulcerative proctitis in November 2004.
- Clinical presentation and serological findings (high IgG and IgA titers) suggested Chlamydia trachomatis infection.
Findings:
- Chlamydia trachomatis was confirmed by culture and PCR in affected specimens.
- Genotyping identified the causative agent as Chlamydia trachomatis serovar L2.
- Treatment with doxycycline for 3-4 weeks proved effective in both cases.
Implications:
- The incidence of LGV is rising among MSM in Europe, with a high proportion of cases involving HIV-1 co-infection.
- Ulcerative sexually transmitted diseases (STDs) can enhance HIV transmission, necessitating increased awareness among healthcare providers and patients.
- Prompt diagnosis and effective treatment with doxycycline are crucial for managing LGV and preventing further transmission.