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• LGV doesn’t spread in the overall Chlamydia trachomatis-infected population in France
  Bertille de Barbeyrac
  Published on: 13 May 2016
• A surgical perspective
  Emma L Marsdin
  Published on: 13 May 2016

• Published on: 13 May 2016

  LGV doesn’t spread in the overall Chlamydia trachomatis-infected population in France

  • Bertille de Barbeyrac, PharmD, phD
  • Other Contributors:
    • Olivia Peuchant, Tsiry Rasamiravaka, Maïthé Clerc, Christiane Bébéar

  Dear Editor,

  Helen Ward (3) ask the question about the extent of the Lymphogranuloma venereum (LGV) in the wider population than that of men who have sex with men (MSM). A rospective sentinel survey set up in France following the European alert in January 2004 tried to answer this question. From April 2002 to December 2008, rectal samples from MSM were collected by the French National Reference Centre for Chlamydia infec...

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  Dear Editor,

  Helen Ward (3) ask the question about the extent of the Lymphogranuloma venereum (LGV) in the wider population than that of men who have sex with men (MSM). A rospective sentinel survey set up in France following the European alert in January 2004 tried to answer this question. From April 2002 to December 2008, rectal samples from MSM were collected by the French National Reference Centre for Chlamydia infections from mainly 3 labs in Paris and some labs in France. All the C. trachomatis-positive rectal samples were genotyped. Over 1041 positive specimens genotyped, 725 L2 serovars and 316 non-LGV associated serovars (mainly Da,G, and J) were identified. Simultaneously, C. trachomatis-positive genital specimens were tested for the presence of LGV strains by a specific genovar L Taqman Real-time PCR (2). A total of 2662 urogenital specimens (1095 urethral or male urine specimens and 1567 vaginal, cervical or female urine specimens) were tested. These specimens were obtained between 2004 and 2008 in Paris, Bordeaux, and from Pasteur Cerba laboratory, a central French laboratory that received specimens from all over the country. No LGV strain was found except one in the urethral male sample of one HIV(+) gay man. This is the second case of urethritis due to a C. trachomatis genovar L2 in France, the first one having been already published in 2006 (1). We can conclude that, in France, LGV remains essentially a rectal infection in MSM.

  Acknowledgments: we thank Dr Georges Kreplack, Patrice Sednaoui, Catherine Scieux Sabine Trombert, for providing C. trachomatis-positive specimens from Paris and Cerba laboratory.

  References

  1. Herida, M., G. Kreplack, B. Cardon, J. C. Desenclos, and B. de Barbeyrac. 2006. First case of urethritis due to Chlamydia trachomatis genovar L2b. Clinical Infectious Diseases 43:268-269.

  2. Morre, S. A., J. Spaargaren, J. S. A. Fennerna, H. J. C. de Vries, R. A. Coutinho, and A. S. Pena. 2005. Real-time polymerase chain reaction to diagnose lymphogranuloma venereum. Emerging Infectious Diseases 11:1311- 1312.

  3. Ward, H., and R. F. Miller. 2009. Lymphogranuloma venereum: here to stay? Sex Transm Infect 85:157.

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  Conflict of Interest:
  None declared.

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• Published on: 13 May 2016

  A surgical perspective

  • Emma L Marsdin, Foundation Year 1 Doctor
  • Other Contributors:
    • Seema Biswas

  Dear Editor,

  Although lymphogranuloma venereum (LGV) as a cause of severe proctitis is well known amongst genitourinary and gastroenterological specialists, it remains absent from a common list of causes of rectal bleeding amongst General Practitioners and Surgeons. An example is a case of a homosexual man who presented as a 2 week rule urgent referral to the Colorectal clinic with painless rectal bleeding and went on...

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  Dear Editor,

  Although lymphogranuloma venereum (LGV) as a cause of severe proctitis is well known amongst genitourinary and gastroenterological specialists, it remains absent from a common list of causes of rectal bleeding amongst General Practitioners and Surgeons. An example is a case of a homosexual man who presented as a 2 week rule urgent referral to the Colorectal clinic with painless rectal bleeding and went on to have endoscopy and biopsies for proctitis. It would not have been unreasonable to start this patient on steroids or mesalazine enemas for symptom control while awaiting the results of biopsies. In this instance, however, it was only after telephone consultation with an HIV specialist and referral to the Genitourinary Medicine clinic that a diagnosis of LGV proctitis was reached several weeks later. Steroids’ would almost certainly have made this condition worse and may even have resulted in a rectal perforation.

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  Conflict of Interest:
  None declared.

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