Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- inguinal lymphadenopathy
- nonspecific symptoms of proctocolitis
- groove sign of Greenblatt
- genital elephantiasis, saxophone penis, esthiomene
Otros factores de diagnóstico
- fever, malaise, arthralgias
- lower abdominal or lower back pain
- genital or anal ulcer
- nonspecific symptoms of bacteremic spread
- erythema nodosum
- anogenital sinus tracts, strictures, or fistulae
Factores de riesgo
- other STIs
- risky sexual behavior
- HIV-seropositivity
- age (20 to 40 years)
- unprotected intercourse in an area endemic for LGV
- male
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- genital or lymph node specimens for nucleic acid amplification testing (NAAT)
- swab via anoscopy for Gram staining
- fluid or swab for LGV-specific molecular testing
- STI testing
Pruebas diagnósticas que deben considerarse
- endoscopy with histopathology
- serum for complement fixation
- serum for microimmunofluorescence (MIF)
- CT of abdomen and pelvis
- MRI of abdomen and pelvis
- fluid or swab for culture
Pruebas emergentes
- fluid or swab for genovar typing
Algoritmo de tratamiento
asymptomatic adolescent and adult patients who have been exposed to lymphogranuloma venereum (LGV)
all stages of lymphogranuloma venereum (LGV)
Colaboradores
Autores
Benjamin D. Lorenz, MD
Assistant Professor
Division of Hospital Medicine
MedStar Georgetown University Hospital
Washington
DC
Divulgaciones
BDL declares that he has no competing interests.
Agradecimientos
Dr Benjamin D. Lorenz would like to gratefully acknowledge Dr Mettassebia Kanno, a previous contributor to this topic.
Divulgaciones
MK declares that she has no competing interests.
Revisores por pares
Cees van Nieuwkoop, MD
Department of General Internal Medicine
Leiden University Medical Centre
Leiden
The Netherlands
Declarações
CvN declares that he has no competing interests.
David Chelmow, MD
Chair
Department of Obstetrics and Gynecology
Virginia Commonwealth University
Richmond
VA
Declarações
DC declares that he has no competing interests.
Créditos aos pareceristas
Os tópicos do BMJ Best Practice são constantemente atualizados, seguindo os desenvolvimentos das evidências e das diretrizes. Os pareceristas aqui listados revisaram o conteúdo pelo menos uma vez durante a história do tópico.
Declarações
As afiliações e declarações dos pareceristas referem--se ao momento da revisão.
Referências
Principais artigos
de Vries HJC, de Barbeyrac B, de Vrieze NHN, et al. 2019 European guideline on the management of lymphogranuloma venereum. J Eur Acad Dermatol Venereol. 2019 Jun 26;33(10):1821-8.Texto completo Resumo
Centers for Disease Control and Prevention. Lymphogranuloma venereum among men who have sex with men - Netherlands, 2003-2004. MMWR Morb Mortal Wkly Rep. 2004 Oct 29;53(42):985-8.Texto completo Resumo
Van der Bij AK, Spaargaren J, Morre SA, et al. Diagnostic and clinical implications of anorectal lymphogranuloma venereum in men who have sex with men: a retrospective case-control study. Clin Infect Dis. 2006 Jan 15;42(2):186-94.Texto completo Resumo
Stamm WE. Lymphogranuloma venereum. In: Holmes KK, Sparling PF, Stamm WE, et al., eds. Sexually transmitted diseases. 4th ed. New York, NY: McGraw Hill; 2007:595-606.
Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep. 2021 Jul 23;70(4):1-187.Texto completo Resumo
Mabey D, Peeling RW. Lymphogranuloma venereum. Sex Transm Infect. 2002 Apr;78(2):90-2.Texto completo Resumo
Thorsteinsson SB. Lymphogranuloma venereum: review of clinical manifestations, epidemiology, diagnosis, and treatment. Scand J Infect Dis Suppl. 1982;32:127-31. Resumo
Annamuthodo H. Rectal lymphogranuloma venereum in Jamaica. Ann R Coll Surg Engl. 1961 Sep;29:141-59.Texto completo Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.

Diagnósticos diferenciais
- Syphilis (Treponema pallidum)
- Gonococcal proctitis
- Genital herpes (HSV)
Mais Diagnósticos diferenciaisDiretrizes
- BASHH summary guidance on testing for sexually transmitted infections, 2023
- Sexually transmitted infections treatment guidelines, 2021
Mais DiretrizesFolhetos informativos para os pacientes
Chlamydia
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