Rectal lymphogranuloma venereum

Mistrangelo, Massimiliano; Conte, Ivano Dal; Gregori, Gabriella; Castellano, Isabella; Famiglietti, Federico; Vries, Henry J C de

doi:10.1111/j.1463-1318.2012.03000.x

Cited by 8 publications

(7 citation statements)

References 8 publications

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“…Most of the cases and controls were coinfected with HIV, in line with other studies in the UK,4 and the one case of incident HIV infection reinforces the recommendation for repeat HIV testing and offer of other risk reduction interventions. Importantly, rectal carcinoma should always be considered in those presenting with bleeding and weight loss; however, cases have been reported where LGV has presented with an ulcerating bleeding mass 28 29…”

Section: Discussionmentioning

confidence: 99%

Clinical predictors of rectal lymphogranuloma venereum infection: results from a multicentre case–control study in the UK

et al. 2014

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ObjectiveSince 2003, over 2000 cases of lymphogranuloma venereum (LGV) have been diagnosed in the UK in men who have sex with men (MSM). Most cases present with proctitis, but there are limited data on how to differentiate clinically between LGV and other pathology. We analysed the clinical presentations of rectal LGV in MSM to identify clinical characteristics predictive of LGV proctitis and produced a clinical prediction model.DesignA prospective multicentre case–control study was conducted at six UK hospitals from 2008 to 2010. Cases of rectal LGV were compared with controls with rectal symptoms but without LGV.MethodsData from 98 LGV cases and 81 controls were collected from patients and clinicians using computer-assisted self-interviews and clinical report forms. Univariate and multivariate logistic regression was used to compare symptoms and signs. Clinical prediction models for LGV were compared using receiver operating curves.ResultsTenesmus, constipation, anal discharge and weight loss were significantly more common in cases than controls. In multivariate analysis, tenesmus and constipation alone were suggestive of LGV (OR 2.98, 95% CI 0.99 to 8.98 and 2.87, 95% CI 1.01 to 8.15, respectively) and that tenesmus alone or in combination with constipation was a significant predictor of LGV (OR 6.97, 95% CI 2.71 to 17.92). The best clinical prediction was having one or more of tenesmus, constipation and exudate on proctoscopy, with a sensitivity of 77% and specificity of 65%.ConclusionsThis study indicates that tenesmus alone or in combination with constipation makes a diagnosis of LGV in MSM presenting with rectal symptoms more likely.

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Section: Discussionmentioning

confidence: 99%

Clinical predictors of rectal lymphogranuloma venereum infection: results from a multicentre case–control study in the UK

et al. 2014

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“… Proctitis (that is proctitis confined to the distal 12–15 cm of the rectum): Mucopus in lumen of rectum; Loss of normal vascular pattern (although note that the vascular pattern may not be apparent in the distal 10 cm of the normal rectum); Mucosal oedema; Contact bleeding; Sometimes ulceration; LGV and syphilis may cause an inflammatory, sometimes ulcerated, tumorous infiltrate in the distal rectum or anal canal. 11,12 …”

Section: Clinical Features Of Proctitis Proctocolitis and Enteritismentioning

confidence: 99%

“…LGV and syphilis may cause an inflammatory, sometimes ulcerated, tumorous infiltrate in the distal rectum or anal canal. 11,12…”

Section: Clinical Features Of Proctitis Proctocolitis and Enteritismentioning

confidence: 99%

2013 European Guideline on the management of proctitis, proctocolitis and enteritis caused by sexually transmissible pathogens

et al. 2013

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Proctitis is defined as an inflammatory syndrome of the distal 10-12 cm of the anal canal, also called the rectum. Infectious proctitis can be sexually transmitted via genital-anal mucosal contact, but some also via mutual masturbation.N. gonorrhoeae,C. trachomatis(including lymphogranuloma venereum), Herpes Simplex Virus andT. pallidumare the most common sexually transmitted anorectal pathogens. Shigellosis can be transferred via oral-anal contact and may lead to proctocolitis or enteritis. Although most studies on these infections have concentrated on men who have sex with men (MSM), a significant proportion of women have anal intercourse and therefore may also be at risk. A presumptive clinical diagnosis of proctitis can be made when there are symptoms and signs, and a definitive diagnosis when the results of laboratory tests are available. The symptoms of proctitis include anorectal itching, pain, cramps (tenesmus) and discharge in and around the anal canal. Asymptomatic proctitis occurs frequently and can only be detected by laboratory tests. The majority of rectal chlamydia and gonococcal infections are asymptomatic. Therefore when there is a history of receptive anal contact, exclusion of anorectal infections is generally indicated as part of standard screening for sexually transmitted infections (STIs). Condom use does not guarantee protection from bacterial and protozoan STIs, which are often spread without penile penetration.

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“…La experiencia clínica señala que el linfogranuloma venéreo responde adecuadamente al tratamiento an-tibiótico, pero si este no es tratado oportunamente puede ocurrir una lesión extensa del tejido, llevando al desarrollo de abscesos complicados, fístulas crónicas y dolor pélvico-abdominal crónico (128). La proctitis por linfogranuloma venéreo es una complicación de la infección que ocurre en hombres y mujeres, puede presentarse con ulceraciones rectales, descarga anal sanguinolenta, fisuras anales y fístulas en región anal, lo que puede desencadenar síntomas constitucionales (129).…”

Section: ¿Cuáles Son Las Complicaciones Más Frecuentes Que Se Presentunclassified

Guía de práctica clínica para el manejo sindrómico de los pacientes con infecciones de transmisión sexual y otras infecciones del tracto genital - 2013

Gaitán-Duarte

Rodríguez-Hernández

Arévalo-Rodríguez

et al. 2013

Rev. Colomb. Obstet. Ginecol.

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Rectal lymphogranuloma venereum

Cited by 8 publications

References 8 publications

Clinical predictors of rectal lymphogranuloma venereum infection: results from a multicentre case–control study in the UK

Clinical predictors of rectal lymphogranuloma venereum infection: results from a multicentre case–control study in the UK

2013 European Guideline on the management of proctitis, proctocolitis and enteritis caused by sexually transmissible pathogens

Guía de práctica clínica para el manejo sindrómico de los pacientes con infecciones de transmisión sexual y otras infecciones del tracto genital - 2013

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