淋巴细胞瘤 (lymphogranuloma venereum proctosigmoiditis) 被误诊为炎症性肠病:一个病例报告
Kaline Maya Khoury1, Ahmad Jradi1, Karam Karam2
1Department of Internal Medicine, University of Balamand, Beirut 100, Beyrouth, Lebanon.
World journal of clinical cases
|May 19, 2025
概括
由Chlamydia trachomatis引起的lymphogranuloma venereum (LGV) proctosigmoiditis可以模仿与男性发生性关系的男性的炎症性肠病 (IBD). 完整的性病史对于准确的诊断和有效的治疗至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 胃肠病学 胃肠病学
- 性健康 性的健康
背景情况:
- 由Chlamydia trachomatis L1-L3血清型引起的Lymphogranuloma venereum (LGV) 的病例增加,主要观察到与男性发生性关系的男性 (MSM).
- 在临床上,LGV可以表现为直肠症状,如出血和排泄,类似于炎症性肠病 (IBD).
- 完整的病史,包括社会和性史,对于指导诊断至关重要.
研究的目的:
- 突出LGV前列腺炎作为高风险人群的关键差异诊断.
- 强调区分LGV和IBD对于适当的患者管理的重要性.
- 强调详细的性史在预防误诊方面的作用.
主要方法:
- 一个38岁的男性病例报告,症状暗示IBD.
- 内镜检查结果显示了直肠西格形,最初被认为是IBD,但通过负面活检被驳斥.
- 诊断通过核酸放大测试证实了Chlamydia trachomatis的阳性,识别了LGV proctosigmoiditis.
主要成果:
- 患者出现了直肠出血,粘膜流水和腹部疼痛.
- 内镜显示出,但活检对IBD是负的.
- 核酸放大测试证实了Chlamydia trachomatis,导致了LGV诊断.
结论:
- 在高风险患者,特别是MSM,呈现出直肠炎症状时,必须考虑LGV直肠炎.
- 区分LGV和IBD对于避免误诊和确保及时治疗至关重要.
- 为了准确诊断和有效管理LGV,全面的性病史至关重要.
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