Lymphogranuloma venereum: Difference between revisions

m (Rossdonaldson1 moved page Lymphogranuloma Venereum to Lymphogranuloma venereum)
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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

  • L1, L2, L3 serovars of Chlamydia trachomatis
  • Sexually transmitted
  • Often co-infected with HIV

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
  • 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

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