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Lymphogranuloma venereum

最后审阅: 21 Sep 2025
最后更新: 11 Mar 2025

小结

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • inguinal lymphadenopathy
  • nonspecific symptoms of proctocolitis
  • groove sign of Greenblatt
  • genital elephantiasis, saxophone penis, esthiomene
Полная информация

Другие диагностические факторы

  • 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
Полная информация

Факторы риска

  • other STIs
  • risky sexual behavior
  • HIV-seropositivity
  • age (20 to 40 years)
  • unprotected intercourse in an area endemic for LGV
  • male
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • 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
Полная информация

Исследования, проведение которых нужно рассмотреть

  • 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
Полная информация

Неотложные исследования

  • fluid or swab for genovar typing

Алгоритм лечения

Начальные

asymptomatic adolescent and adult patients who have been exposed to lymphogranuloma venereum (LGV)

Острый

all stages of lymphogranuloma venereum (LGV)

Составители

Авторы

Benjamin D. Lorenz, MD

Assistant Professor

Division of Hospital Medicine

MedStar Georgetown University Hospital

Washington

DC

Раскрытие информации

BDL declares that he has no competing interests.

Выражение благодарностей

Dr Benjamin D. Lorenz would like to gratefully acknowledge Dr Mettassebia Kanno, a previous contributor to this topic.

Раскрытие информации

MK declares that she has no competing interests.

Рецензенты

Cees van Nieuwkoop, MD

Department of General Internal Medicine

Leiden University Medical Centre

Leiden

The Netherlands

Раскрытие информации

CvN declares that he has no competing interests.

David Chelmow, MD

Chair

Department of Obstetrics and Gynecology

Virginia Commonwealth University

Richmond

VA

Раскрытие информации

DC declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

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.Полный текст  Аннотация

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.Полный текст  Аннотация

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.Полный текст  Аннотация

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.Полный текст  Аннотация

Mabey D, Peeling RW. Lymphogranuloma venereum. Sex Transm Infect. 2002 Apr;78(2):90-2.Полный текст  Аннотация

Thorsteinsson SB. Lymphogranuloma venereum: review of clinical manifestations, epidemiology, diagnosis, and treatment. Scand J Infect Dis Suppl. 1982;32:127-31. Аннотация

Annamuthodo H. Rectal lymphogranuloma venereum in Jamaica. Ann R Coll Surg Engl. 1961 Sep;29:141-59.Полный текст  Аннотация

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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