小结
Определение
Анамнез и осмотр
Ключевые диагностические факторы
- inguinal lymphadenopathy
- nonspecific symptoms of proctocolitis
- groove sign of Greenblatt
- genital elephantiasis, saxophone penis, esthiomene
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
Факторы риска
- other STIs
- risky sexual behavior
- HIV-seropositivity
- age (20 to 40 years)
- unprotected intercourse in an area endemic for LGV
- male
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
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
Неотложные исследования
- fluid or swab for genovar typing
Алгоритм лечения
asymptomatic adolescent and adult patients who have been exposed to lymphogranuloma venereum (LGV)
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
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.
Отличия
- Syphilis (Treponema pallidum)
- Gonococcal proctitis
- Genital herpes (HSV)
Больше ОтличияРекомендации
- BASHH summary guidance on testing for sexually transmitted infections, 2023
- Sexually transmitted infections treatment guidelines, 2021
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