CASE REPORT

First case of "bubonulus" in L2 lymphogranuloma venerum

Nathalie Spenatto⁴, Serge Boulinguez¹, Bertille de Barbeyrac² and Roland Viraben³

¹ CIDDIST Hôpital La Grave, Toulouse, France
² Service de Bacteriologie, National Reference Centre of Chlamydia Infection, Bordeaux, France
³ Service de Dermatologie, Toulouse, France
⁴ CIDDIST Hôpital La Grave, Place Lange, 31059 Toulouse Cedex 9, France

Correspondence to:
Correspondence to:
Dr Nathalie Spenatto
CIDDIST Hôpital La Grave, Place Lange, 31059 Toulouse Cedex 9, France; spenatto.n{at}chu-toulouse.fr

Since 2003, an ongoing lymphogranuloma venereum (LGV) proctitis outbreak has been reported in industrialised countries with a new variant designated L2b. Only men who have sex with men (MSM) are affected and most are HIV co-infected; delayed or incorrect diagnoses are frequent. We report a rare clinical case of LGV primary stage called "bubonulus" with penile adenopathy and secondary local acute lymphoedema in an MSM seropositive man. This is the first case described of this clinical presentation with a L2b genovar strain, occurring immediately after use of a sex toy. It suggests that this presentation is favoured by host immunity and behavioural factors. These factors may also play a part in the new outbreak of LGV.

Abbreviations: HAART, highly active antiretroviral therapy; LGV, lymphogranuloma venereum; MSM, men who have sex with men; PCR, polymerase chain reaction

Keywords: sexually transmitted disease; lymphogranuloma venereum; bubonulus; chlamydia trachomatis; penile adenopathy

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