Delayed diagnosis of lymphogranuloma venereum in a hospital setting – a retrospective observational study

Abstract

Objective: The incidence of lymphogranuloma venereum (LGV) in Europe is increasing. However, diagnosing LGV in a hospital setting is rare. We analysed the diagnostic process and clinical characteristics of patients with LGV in a hospital setting. Design and setting: A retrospective observational study conducted in a teaching hospital in Amsterdam, The Netherlands. All adult patients with LGV between November 2010 and February 2019 were included. Clinical data were retrieved from electronic patient records. Results: 40 patients were included. 90% of patients were men who have sex with men (MSM) and 62,5% were HIV positive. The most common presenting symptoms were rectal bleeding (47,5%), anal symptoms (30%) and change in bowel habits (25%). The mean time from first consultation to diagnosis was 28 days (range: 0 to 332, median 16,5 days). Diagnostic delay was increased by clinical presentation (ie anogenital syndrome) and the number of specialists involved. Diagnostic procedures not leading to the diagnosis were performed in 98% of cases. Conclusion: To prevent late complications, unnecessary diagnostic procedures and further transmission, early testing for LGV should be incorporated in the work-up of every patient reporting MSM-activity presenting with anorectal symptoms or inguinal lymphadenopathy.

Cluster analysis for symptomatic management of Neisseria gonorrhoea and Chlamydia trachomatis in sexually transmitted infections related clinics in China

“…A study showed that among those with a confirmed NG or CT visit, balanitis was observed in 24% of cases and genital warts in 12% of cases ( 25 ). Lymphogranuloma venereum (LGV) is caused by CT, and 22.5% of infections had symptoms of inguinal lymph node enlargement ( 26 ). Therefore, it would be useful to link these symptoms with NG and CT when offering symptomatic management.…”