RT Journal Article
SR Electronic
T1 Pitfalls in the diagnosis and management of inguinal lymphogranuloma venereum: important lessons from a case series
JF Sexually Transmitted Infections
JO Sex Transm Infect
FD BMJ Publishing Group Ltd
SP 279
OP 282
DO 10.1136/sextrans-2013-051427
VO 90
IS 4
A1 Emerentiana Veronica Oud
A1 Nynke Hesselina Neeltje de Vrieze
A1 Arjan de Meij
A1 Henry John C de Vries
YR 2014
UL http://sti.bmj.com/content/90/4/279.abstract
AB Current lymphogranuloma venereum (LGV) guidelines mainly focus on anorectal infections. Inguinal LGV infections have been rare in the current epidemic among men who have sex with men (MSM), but might require a different approach not yet recommended in current guidelines for the treatment and diagnosis of LGV. We describe 4 inguinal LGV cases. Three MSM developed inguinal LGV infection several weeks after a previous consultation, of which two had received azithromycin after being notified for LGV. Three failed the recommended 21 days doxycycline treatment. These inguinal LGV cases highlight 3 pitfalls in the current standard management of LGV: 1) Urethral chlamydia infections in MSM can be caused by LGV biovars that in contrast to non-LGV biovars require prolonged antibiotic therapy. 2) The recommended one gram azithromycin contact treatment seems insufficient to prevent established infections. 3) Inguinal LGV may require prolonged courses of doxycycline, exceeding the currently advised 21 days regimen.