Slow Epidemic of Lymphogranuloma Venereum L2b Strain

Spaargaren, Joke; Schachter, Julius; Moncada, Jeanne; Vries, Henry J C de; Fennema, H; Peña, Amado Salvador; Coutinho, Roel A.; Morré, Servaas A.

doi:10.3201/eid1111.050821

Cited by 92 publications

(61 citation statements)

References 7 publications

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“…Nevertheless, this variant seems to have been circulating in the NL since 2000 (no earlier samples were available) and has also been detected retrospectively in rectal samples from symptomatic MSM collected from 1979 to 1985 in San Francisco (LGV represented 13% of the collected samples and 67.3% of the C. trachomatispositive samples) [45]. This fact could support the hypothesis proposed by some authors of the existence of an ongoing unrecognised endemic disease among MSM for at least 20 years rather than a new outbreak [45,46]. However, other countries have not confirmed the retrospective detection of undiagnosed cases in stored samples [8,39,47].…”

Section: Epidemiologysupporting

confidence: 77%

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Lymphogranuloma venereum proctocolitis: a silent endemic disease in men who have sex with men in industrialised countries

Martín-Iguacel

Llibre

Nielsen

et al. 2010

Eur J Clin Microbiol Infect Dis

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Lymphogranuloma venereum (LGV) is a sexually transmitted disease (STD) caused by serovars L1-L3 of Chlamydia trachomatis. Rare in the western world prior to 2003, different outbreaks or clusters of LGV have been reported in Europe, North America and Australia among men who have sex with men (MSM) over the past few years. The majority were HIV infected MSM with high-risk sexual behaviour and a high rate of concomitant STD, including hepatitis C. Most of them presented with a proctitis syndrome and only a few with the classical bubonic form. A previously non-described serovar, L2b, has been identified as the main causative agent of the epidemic. A delay in diagnosis has been the rule because of the misleading symptomatology of LGV proctitis, the unfamiliarity of the disease to physicians, and the lack of a routine diagnostic test for LGV serovars. It is crucial to increase the awareness of the disease among physicians for prompt diagnosis and treatment, to avoid complications, and to stop ongoing transmission. It has additional public health implications since LGV may facilitate the transmission and acquisition of HIV and other STD.

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Section: Epidemiologysupporting

confidence: 77%

“…On the other hand, the absence of the classical clinical features of LGV have also conditioned a delay in the diagnosis and treatment in the current outbreak as evidenced by the large number of cases diagnosed retrospectively, allowing ongoing transmission [5,8,11,43,46].…”

Section: Clinical Syndromementioning

confidence: 99%

Lymphogranuloma venereum proctocolitis: a silent endemic disease in men who have sex with men in industrialised countries

Martín-Iguacel

Llibre

Nielsen

et al. 2010

Eur J Clin Microbiol Infect Dis

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“…Besides the defined serovar, genovariants have 66 been described including Ja and L2b (7,8). 67 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 3 69 The majority of serovars A, B and C are detected in conjunctival samples of patients in 70 developing countries, while serovars D-K are mostly found in the urogenital tract and 71 proctum and remain confined to the mucosal layer.…”

mentioning

confidence: 99%

Comparison of three genotyping methods to identify Chlamydia trachomatis genotypes in positive men and women

Quint

Bom

Bruisten

et al. 2010

Molecular and Cellular Probes

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“…Retrospektív vizsgálatok az 1980-as években tárolásra került San Franciscó-i anorectalis mintákban is megtalálták az L2b variánst, amely felvetette egy régóta lappangó járvány lehetőségét is [20].…”

Section: Esetismertetésunclassified

“…Az előbb részletezett kockázati tényezőket, a tünet-mentesség lehetőségét és a várható szövődmények sú-lyosságát fi gyelembe véve a 2013. januárban kiadott IUSTI európai ajánlás javasolja minden olyan MSM-csoportba tartozó egyénnél, aki az elmúlt 6 hónapban tör-tént szexuális aktus során receptív fél volt, szűrővizsgálat jelleggel a nem specifi kus Chlamydia trachomatis NAATteszt, majd ennek pozitivitása esetén LGV-specifi kus PCR-vizsgálat elvégzését az anorectalis váladékból [20]. Hollandiában ezzel szemben egyes helyeken az MSMpopulációba tartozó és anorectalis panasszal jelentkező vagy HIV-fertőzött és bármilyen STD-panasszal jelentkező minden betegnél specifi kus LGV-PCR vizsgálatot végeznek az anorectalis váladékból [24].…”

Section: Esetismertetésunclassified

Lymphogranuloma venereum – the first Hungarian cases

et al. 2015

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A lymphogranuloma venereum a Chlamydia trachomatis L1-3 szerovariánsa által terjesztett nemi betegség, amely korábban elsősorban a trópusi éghajlatú országokban volt elterjedt. Az elmúlt évtizedekben Nyugat-Európában szá-mos esetet jelentettek, elsősorban a humán immundefi cientia vírus fertőzött homoszexuális férfi populációban. A szerzők intézetében 2013-ban két esetet, 2014-ben egy esetet diagnosztizáltak. A szerzők e három humán immundefi cientia vírus fertőzött homoszexuális férfi kórtörténetét ismertetik, akik nyugat-európai tartózkodásuk alatti alkalmi kapcsolatok során fertőződtek meg. Két esetben urethralis fl uor, diszkomfort és inguinalis lymphadenomegalia, egy esetben analis diszkomfort, illetve perianalis ulceratio volt a vezető klinikai tünet. Az urethralis váladékból, illetve a perianalis ulcus váladékából végzett célzott real-time polimeráz láncreakció vizsgálat eredménye két esetben lymphogranuloma venereum L2b, egy esetben L2 szerovariánst igazolt. Doxycyclinkezelést követően a betegek gyógyul-tak. A lymphogranuloma venereum a jövőben vélhetően fokozódó kihívást jelent, így ismerete számos szakterületen fontos a késői szövődmények megelőzése és a kórkép további terjedésének megállítása céljából. Orv. Hetil., 2015, 156(1), 36-40. Kulcsszavak: lymphogranuloma venereum, Chlamydia trachomatis, HIV, MSM Lymphogranuloma venereum -the fi rst Hungarian casesLymphogranuloma venereum is a sexually transmitted infection caused by the Chlamydia trachomatis serovars L1-3. It has been found to be endemic in tropical countries. In the last decades several cases have been reported in Western Europe, particularly in men who have sex with men population infected with human immunodefi ciency virus. The authors present three cases of lymphogranuloma venereum infections, observed at their department in 2013 and 2014. The three human immunodefi ciency virus infected patients who belonged to men who have sex with men population had casual sexual contacts in Western Europe. The symptoms included urethral discharge, discomfort and inguinal lymphadenomegaly in two patients, and rectal pain, discharge and perianal ulceration in one patient. The diagnosis was confi rmed by nucleic acid amplifi cation test performed in samples obtained from urethral discharge and exudate of perianal ulcer; lymphogranuloma venereum 2b serovars were demonstrated in two patients and serovar 2 in one patient. Doxycyclin (daily dose of two times 100 mg for 21 days) resolved the symptoms in all cases. The authors conclude that lymphogranuloma venereum is a diagnostic challenge in Hungary, too. It is important to be aware of the altered clinical features of this disease to prevent complications and spreading.

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Slow Epidemic of Lymphogranuloma Venereum L2b Strain

Cited by 92 publications

References 7 publications

Lymphogranuloma venereum proctocolitis: a silent endemic disease in men who have sex with men in industrialised countries

Lymphogranuloma venereum proctocolitis: a silent endemic disease in men who have sex with men in industrialised countries

Comparison of three genotyping methods to identify Chlamydia trachomatis genotypes in positive men and women

Lymphogranuloma venereum – the first Hungarian cases

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