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
Divulgaciones
CvN declares that he has no competing interests.
David Chelmow, MD
Chair
Department of Obstetrics and Gynecology
Virginia Commonwealth University
Richmond
VA
Divulgaciones
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.
Referencias
Artículos principales
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 Resumen
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 Resumen
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 Resumen
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 Resumen
Mabey D, Peeling RW. Lymphogranuloma venereum. Sex Transm Infect. 2002 Apr;78(2):90-2.Texto completo Resumen
Thorsteinsson SB. Lymphogranuloma venereum: review of clinical manifestations, epidemiology, diagnosis, and treatment. Scand J Infect Dis Suppl. 1982;32:127-31. Resumen
Annamuthodo H. Rectal lymphogranuloma venereum in Jamaica. Ann R Coll Surg Engl. 1961 Sep;29:141-59.Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
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Más DiferencialesGuías de práctica clínica
- BASHH summary guidance on testing for sexually transmitted infections, 2023
- Sexually transmitted infections treatment guidelines, 2021
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