(BQ) Part 2 book “Current diagnosis & treatment of sexually transmitted diseases” has contents: Lymphogranuloma venereum, sexually transmitted diseases in pregnancy, sexually transmitted diseases in adolescents, commonly encountered genital dermatoses, and other contents. | Lymphogranuloma Venereum 17 Christopher S. Hall, MD, MS ESSENTIALS OF DIAGNOSIS • In North America, lymphogranuloma venereum typically presents as a proctitis syndrome; elsewhere, genital ulcer disease followed by inguinal lymphadenopathy with or without bubo formation may predominate. • Diagnostic tests include culture and typing for Chlamydia trachomatis and molecular assays. • Patients should be asked about gender of sex partners and travel to areas of endemic disease or outbreaks, and behavioral risk assessment should be performed to elicit risks for transmission. • In patients with suspected infection, screening for other STDs, including HIV, is warranted. General Considerations Lymphogranuloma venereum (LGV) is a systemic sexually transmitted disease (STD) caused by L1, L2, and L3 serovars (subtypes) of Chlamydia trachomatis. LGV occurs worldwide as several clinical syndromes, the most common of which are characterized by papules or ulcers with inguinal lymphadenopathy, followed by proctitis (see Table 17–1). Although LGV is classically an invasive, inflammatory infection, patients may present without significant lymphadenopathy or with mild symptoms. Asymptomatic infection also has been observed. LGV is endemic in some regions (Africa, Southeast Asia, Central and South America, and Caribbean countries) while occurring sporadically in others. It remains infrequent in the United States. However, case clusters have been reported in the northern hemisphere since 2002. Notably, an outbreak of 92 cases of proctitis caused by LGV was described among men who have sex with men (MSM) in the Netherlands in 2003–2004. Since then, case clusters have been reported in Belgium, France, Sweden, and Canada, with fewer than two dozen confirmed cases reported throughout the United States by 2005. Recent outbreaks and case clusters demonstrate the need for heightened awareness of this STD in the United States. LGV should be considered in those at risk for STDs, especially .
