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Lymphogranuloma venereum: diagnostic and treatment challenges

Authors Ceovic R, Jerkovic Gulin S

Received 22 January 2015

Accepted for publication 17 February 2015

Published 27 March 2015 Volume 2015:8 Pages 39—47

DOI https://doi.org/10.2147/IDR.S57540

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Professor Suresh Antony

Romana Ceovic,1 Sandra Jerkovic Gulin2

1Department of Dermatology and Venereology, University Hospital Center Zagreb and School of Medicine, Zagreb, Croatia; 2Department of Dermatology and Venereology, General Hospital Sibenik, Sibenik, Croatia

Abstract: Lymphogranuloma venereum is a sexually transmitted disease caused by L1, L2, and L3 serovars of Chlamydia trachomatis. In the last 10 years outbreaks have appeared in North America, Europe, and Australia in the form of proctitis among men who have sex with men. Three stages of disease have been described. The disease in primary stage may go undetected when only a painless papule, pustule, or ulceration appears. The diagnosis is difficult to establish on clinical grounds alone and frequently relies upon either serologic testing, culture, or more recently, nucleic acid amplification testing of direct specimens. A proper treatment regimen cures the infection and prevents further damage to tissues. Lymphogranuloma venereum causes potentially severe infections with possibly irreversible sequels if adequate treatment is not begun promptly. Early and accurate diagnosis is essential. Doxycycline is the drug of choice. Pregnant and lactating women should be treated with erythromycin or azithromycin. Patient must be followed up during the treatment, until disease signs and symptoms have resolved. Repeated testing for syphilis, hepatitis B and C, and HIV to detect early infection should be performed.

Keywords: sexually transmitted disease, Chlamydia trachomatis, early and accurate diagnosis

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