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Extra-rectal lymphogranuloma venereum in France: a clinical and molecular study
  1. Arnaud Desclaux1,
  2. Arabella Touati2,3,
  3. Didier Neau1,2,
  4. Cécile Laurier-Nadalié2,3,
  5. Cécile Bébéar2,3,
  6. Bertille de Barbeyrac2,3,
  7. Charles Cazanave1,3,2
  1. 1CHU Bordeaux, Service des Maladies Infectieuses et Tropicales, F-33000 Bordeaux, France
  2. 2Univ. Bordeaux, USC EA 3671, Infections humaines à mycoplasmes et chlamydiae, F-33000 Bordeaux, France
  3. 3Institut National de la Recherche Agronomique, USC EA 3671, Infections humaines à mycoplasmes et chlamydiae, F-33000 Bordeaux, France
  1. Correspondence to Dr Arnaud Desclaux, CHU Bordeaux, Service des Maladies Infectieuses et Tropicale, F-33000 Bordeaux, France; arnaud.desclaux{at}chu-bordeaux.fr

Abstract

Objectives To describe a series of extrarectal lymphogranuloma venereum (LGV) cases diagnosed in France.

Methods Consecutive LGV cases confirmed at the French Reference Centre for chlamydiae with an extrarectal sample from January 2010 to December 2015 were included. The first part of the study consisted of a retrospective case note review and analysis. In a second part, the complete ompA gene sequence of our samples was determined.

Results There were 56 cases overall: 50 cases of genital LGV and six cases of pharyngeal LGV. Subjects were all men, median age 39 years, 27/53 were HIV-positive, 47/51 reported having sex with other men, 43/49 reported multiple sexual partners (a mean 25 in the last 6 months). Median time from symptom onset to diagnosis was 21 days. Subjects most commonly presented with inguinal adenopathy alone (19 of 50 genital cases) and adenopathy with genital ulcer (17 of 50). Three pharyngeal cases were symptomatic. Fever was reported in 11 cases. Inguinal abscess was reported in 22 of 42 cases presenting with lymphadenopathy. Co-infections were frequent: eight cases of syphilis, four non-LGV Chlamydia trachomatis infections, one case of gonorrhoea. Cure was always achieved with doxycycline therapy but prolonged treatment was necessary in eight cases with inguinal abscess. Genotyping according to ompA sequencing showed the co-circulation of genovars L2 (16 of 42 strains successfully typed) and L2b (24 of 42). There was no association between HIV status and disease severity or genovar distribution.

Conclusion In the span of 6 years, 56 extrarectal LGV cases were confirmed through genotyping in France. Extrarectal LGV seemed to share a common epidemiological background with rectal disease in terms of affected population and genovar distribution. HIV prevalence was lower than expected.

  • chlamydia
  • lymphogranuloma venereum
  • lymphadenopathy
  • genital ulcer
  • HIV

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Footnotes

  • Contributors AD, BdB and CC wrote the paper. AT performed the molecular analyses, and described and reviewed the paper. CL-N performed statistical analysis. DN and CB reviewed and corrected the paper.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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