Lymphogranuloma venereum (LGV) is a sexually transmitted infection caused by L1, L2, L3 serovars of C. trachomatis (CT). Since 2003, LGV cases have been increasing in Europe. Aim of this report is to describe the LGV cases diagnosed in the largest STI center in Rome, Italy, from 2000 to 2016. This report shows that two clinically and epidemiologically different series of cases exist, and that, at present, the ano-rectal LGV represents the clinical variant occurring more frequently among men having sex with men (MSM), particularly those HIV-infected.
Ten cases of LGV were observed. Three were diagnosed in 2009 in HIV-negative heterosexuals patients that presented the classical genito-ulcerative form with lymphadenopathy. Seven cases were observed in 2015–2016 in HIV-infected MSM, that presented the rectal variant and L2b serovar infection; 4 of these had been misclassified as a chronic bowel disease.
Chlamydia infection was confirmed by CT-specific PCR (ompA gene nested PCR), followed by sequence analysis to identify the serovar.
All the patients were treated with doxycycline for 3 weeks, obtaining a complete response with healing of both clinical symptoms and dermatological lesions.
Our findings suggest that, in case of persistent rectal symptoms in HIV-infected MSM, LGV should be taken into account and investigated through molecular analyses, in order to achieve a correct diagnosis and management of the patients.
Centers for Disease Control and Prevention (CDC). Lymphogranulomavenereum among men who have sex with men-Netherlands, 2003–2004. MMWR Morb Mortal Wkly Rep. 2004;53(42):985–8. PMid:15514580.
Hughes G, Alexander S, Simms I, et al. Exponential growth of lymphogranuloma venereum diagnosis in the UK: investigation of the largest documented outbreak among men who have sex with men. Sex Transm Infect. 2011;87:A143. CrossRef
Martì-Pastor M, Garcia de Olalla P, Barbera MJ et al. Epidemiology of infections by HIV, Syphilis, Gonorrhea a Lymphogranuloma Venereum in Barcelona City: a population-based incidence study. MC Public Health 2015;15:1015. doi: 10.1186/s12889-015-2344-7. PMid:15905679.
European Centre for Disease Prevention and Control. Sexually transmitted infections in Europe 2013. Stockholm: ECDC; 2015. http://ecdc.europa.eu/en/publications/_layouts/forms/Publication_DispForm.aspx?List=4f55ad51-4aed-4d32-b960-af70113dbb90&ID=1373. Accessed 29 May 2017.
Lýsen M, Österlund A, Rubin CJ, Persson T, Persson I, Herrmann B. Characterization of OmpA genotypes by sequence analysis of DNA from all detected cases of Chlamydia trachomatis infections during 1 year of contact tracing in a Swedish country. J ClinMicrobiol. 2004;42:1641–7.
Lanjouw E, Oubuurg S, de Vries HJ, Stary A, Radcliffe K, Unemo M. 2015 European guideline on the management of Chlamydia trachomatis infections. Int J STD AIDS. 2015; doi: 10.1177/095646241561883.
European Centre for Disease Prevention and Control. Guidance on Chlamydia control in Europe – 2015. Stockholm: ECDC; 2016. http://ecdc.europa.eu/en/publications/_layouts/forms/Publication_DispForm.aspx?List=4f55ad51-4aed-4d32-b960-af70113dbb90&ID=1445. Accessed 29 May 2017.
Cusini M, Boneschi V, Tanzi C, Giegenti V, de Vries H, Alessi E. Anorectallymhgranulomavenereum: the first case in Italy. G ItalDermatolVenereol. 2008;143:83–5.
Foschi C, Filippini A, D’Antuono A, et al. Lymphogranulomavenereum in an Italian MSM: concurrent pharyngeal and rectal infection. New Microbiologic. 2014;37:399–402.
de Vrieze HJC, Van derBij AK, Fennema JSA, et al. Lymphogranulomavenereumproctitis in men who have sex with men is associated with enema use and high risk behavior. Sex Transm dis. 2008;35:203–8. CrossRef
- Inguinal and anorectal Lymphogranuloma Venereum: a case series from a sexually transmitted disease center in Rome, Italy
Maria Grazia Paglia
Maria Gabriella Donà
- BioMed Central
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