Lymphogranuloma venereum: Difference between revisions
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==Background== | ==Background== | ||
* L1, L2, L3 serovars of Chlamydia trachomatis | * L1, L2, L3 serovars of [[Chlamydia]] trachomatis | ||
* Sexually transmitted | * Sexually transmitted | ||
* Often co-infected with HIV | * Often co-infected with [[HIV]] | ||
==Clinical Features== | ==Clinical Features== | ||
* 1st stage: Self-limited painless genital papules/ulcers | * 1st stage: Self-limited painless genital papules/ulcers | ||
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* 3rd state: Proctocolitis | * 3rd state: Proctocolitis | ||
** Rectal pain, discharge, bleeding, fistula, abscess, strictures | ** Rectal pain, discharge, bleeding, fistula, abscess, strictures | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
* HSV-2 | * [[HSV-2]] | ||
* Syphilis | * [[Syphilis]] | ||
* Chancroid | * [[Chancroid]] | ||
* Colitis | * [[Colitis]] | ||
* Granuloma inguinale | * [[Granuloma inguinale]] | ||
==Workup== | ==Workup== | ||
* NAAT or immunofluorescence | * NAAT or immunofluorescence | ||
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* HIV testing | * HIV testing | ||
* May warrant anoscopy | * May warrant anoscopy | ||
==Management== | ==Management== | ||
* Doxycycline 100mg PO BID x 21 days (TOC) or | * [[Doxycycline]] 100mg PO BID x 21 days (TOC) or | ||
* Erythromycin base 500mg PO qid x 21 days | * [[Erythromycin]] base 500mg PO qid x 21 days | ||
* + Ceftriaxone 250mg IM x 1 if proctocolitis | * + [[Ceftriaxone]] 250mg IM x 1 if proctocolitis | ||
** Preferred for pregnant and lactating females | ** Preferred for pregnant and lactating females | ||
* Treat sexual partner | * Treat sexual partner | ||
** If asymptomatic: Doxycycline 100mg PO BID x 7 days or azithromycin 1gm PO 1 once | ** If asymptomatic: [[Doxycycline]] 100mg PO BID x 7 days or [[azithromycin]] 1gm PO 1 once | ||
==Disposition== | |||
==[[Disposition]]== | |||
* Instruct patient to abstain from sexual activities | * Instruct patient to abstain from sexual activities | ||
==See Also== | |||
*[[STDs]] | |||
==Sources== | ==Sources== | ||
<references/> | <references/> | ||
* Zenilman JM, et al. Lymphogranuloma venereum. In: Post T, ed. UpToDate. Waltham, Mass.: UpToDate; 2014. www.uptodate.com. Accessed December 24, 2014. | * Zenilman JM, et al. Lymphogranuloma venereum. In: Post T, ed. UpToDate. Waltham, Mass.: UpToDate; 2014. www.uptodate.com. Accessed December 24, 2014. | ||
* Arsove P, et al. (2014, Jun 30). Lymphogranuloma Venereum. eMedicine. Retrieved 12/24/2014 from http://emedicine.medscape.com/article/220869-overview | * Arsove P, et al. (2014, Jun 30). Lymphogranuloma Venereum. eMedicine. Retrieved 12/24/2014 from http://emedicine.medscape.com/article/220869-overview | ||
[[Category:ID]] | |||
Revision as of 03:47, 28 December 2014
Background
Clinical Features
- 1st stage: Self-limited painless genital papules/ulcers
- 2nd stage: Painful Inguinal +/or femoral LAN
- Systemic: Fever, myalgia, malaise
- Arthritis, ocular dz, cardiac, pulmonary, aseptic meningitis, hepatitis
- Systemic: Fever, myalgia, malaise
- 3rd state: Proctocolitis
- Rectal pain, discharge, bleeding, fistula, abscess, strictures
Differential Diagnosis
Workup
- NAAT or immunofluorescence
- Culture (Needle aspiration at bubo)
- Seology
- HIV testing
- May warrant anoscopy
Management
- Doxycycline 100mg PO BID x 21 days (TOC) or
- Erythromycin base 500mg PO qid x 21 days
- + Ceftriaxone 250mg IM x 1 if proctocolitis
- Preferred for pregnant and lactating females
- Treat sexual partner
- If asymptomatic: Doxycycline 100mg PO BID x 7 days or azithromycin 1gm PO 1 once
Disposition
- Instruct patient to abstain from sexual activities
See Also
Sources
- Zenilman JM, et al. Lymphogranuloma venereum. In: Post T, ed. UpToDate. Waltham, Mass.: UpToDate; 2014. www.uptodate.com. Accessed December 24, 2014.
- Arsove P, et al. (2014, Jun 30). Lymphogranuloma Venereum. eMedicine. Retrieved 12/24/2014 from http://emedicine.medscape.com/article/220869-overview