TY - JOUR
T1 - Pitfalls in the diagnosis and management of inguinal lymphogranuloma venereum: important lessons from a case series
AU - Oud, Emerentiana Veronica
AU - de Vrieze, Nynke Hesselina Neeltje
AU - de Meij, Arjan
AU - de Vries, Henry John C.
PY - 2014
Y1 - 2014
N2 - 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
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
U2 - https://doi.org/10.1136/sextrans-2013-051427
DO - https://doi.org/10.1136/sextrans-2013-051427
M3 - Article
C2 - 24787368
SN - 1368-4973
VL - 90
SP - 279
EP - 282
JO - Sexually transmitted infections
JF - Sexually transmitted infections
IS - 4
ER -