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Lymphogranuloma venereum | inguinale |Causes and treatment



It is an infection by bacteria of the genus Chlamydia. It is transmitted by sexual activity. One to two weeks after infection, a small papule or vesicle appears in the genitalia. One to two weeks after the onset of the skin lesion, fever and swelling occur in lymph nodes in the groin and thighs. It occurs most frequently in tropics.
It is an infection by bacteria of the genus Chlamydia






Pathogenesis
Lymphogranuloma venereum is caused by the Chlamydia trachomatis serovars L1-3.

Clinical presentation

Lymphogranuloma venereum occurs most frequently in the tropics. Several days after infection, a small herpes simplex-like papule of 1 mm in diameter occurs singly on the genitalia or anus. The skin lesion is asymptomatic and heals unnoticed.

About 1 week later, systemic symptoms such as fever and splenohepatomegaly occur. The regional lymph node becomes firm, swollen and ruptures, discharging pus. The inguinal lymph node of men and the anorectal lymph node of women are often involved. In women there may be vulvar lymphatic edema, elephantiasis- like change, or urethral or rectal stenosis (esthiomène).

Diagnosis and Treatment

Antigen test and PCR are conducted. Chlamydia trachomatis is detected from the skin lesion or lymph fluid by microscopy. Frei test, an intradermal test using fluid taken from the patient’s lymph node, is no longer conducted. Skin biopsy must not be performed, because it may lead to fistula formation. Tetracycline and macrolide drugs are administered orally.



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