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The article by Waalboer and colleagues (STI 2006;82:207-211)
precipitated a déjà vu experience for me- albeit along with something new.
They describe a bimodal presentation of chlamydial proctitis in MSM- some
with more severe rectal symptoms caused by LGV serovars and the rest with
much milder rectal disease caused by the D-K serovars.
In 1975 as part of my MD thesis undertaken at The Londo...
In 1975 as part of my MD thesis undertaken at The London Hospital I
looked at MSM who had non gonococcal proctitis. I defined this as mucosal
hyperaemia and/ or an excess of polymorphs in rectal exudate. Chlamydial
isolation was by inoculation of irradiated McCoy cells by John Treharne at
London’s Institute of Ophthalmology
Chlamydia was isolated in only 2 of 48 MSM with low grade proctitis
(none had LGV clinically) but in none of 35 control MSM who did not have
proctitis. Another 3 of the men with proctitis had a significant rise in
Micro IF antibody levels (1 in 8 or greater).
All 28 of the 48 men whose Micro IF antibodies were positive showed
serovars in the D-K groups only. No antibodies to LGV were found.
I understand this to mean at least in one large GU clinic in London
in the mid 1970s I saw no MSM who had current or past LGV, in spite of the
fact that unsafe sex was very common in those pre HIV times.