ABSTRACT
A patient with proctitis and inguinal buboes diagnosed with lymphogranuloma venereum (LGV) was treated with doxycycline 21 days, azithromycin 20 days and moxifloxacin for a further 12 days because of progressive worsening of inguinal symptoms. Despite extensive antibiotic treatment, the inguinal LGV lesions persisted; however, the patient recovered spontaneously after three months.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Chlamydia trachomatis/isolation & purification , Lymphogranuloma Venereum/diagnosis , Lymphogranuloma Venereum/drug therapy , Proctitis/diagnosis , Aza Compounds/therapeutic use , Azithromycin/therapeutic use , Chlamydia trachomatis/genetics , Doxycycline/therapeutic use , Fluoroquinolones , Homosexuality, Male , Humans , Lymphogranuloma Venereum/microbiology , Male , Middle Aged , Moxifloxacin , Multilocus Sequence Typing , Proctitis/drug therapy , Proctitis/microbiology , Quinolines/therapeutic use , Real-Time Polymerase Chain Reaction , Treatment FailureABSTRACT
SUMMARY: The aim of this study was to determine if a reservoir of sub-clinical LGV infection exists in men who have sex with men (MSM), as this finding might account for the recent rise in lymphogranuloma venereum (LGV) Chlamydia trachomatis infections among MSM in Canada. MSM without proctitis were enrolled between January and August 2006 in a cross-sectional study. Rectal, urine, serology and pharyngeal specimens were tested for specific C. trachomatis serovars. The median age of the 253 participants was 43 years; 53% were HIV+. We found no active cases of LGV infection; but 20 (8%) participants had positive serology. Thirteen participants (5%) had non-LGV C. trachomatis infections. Unprotected anopenetrative intercourse, rectal enema and drug use were associated with non-LGV C. trachomatis infection. Sub-clinical rectal non-LGV C. trachomatis infection was relatively common but LGV was not identified in our sample. Further studies of screening for non-LGV chlamydia infection in MSM are needed.
Subject(s)
Chlamydia Infections/microbiology , Chlamydia trachomatis/isolation & purification , Genital Diseases, Male/microbiology , Homosexuality, Male , Lymphogranuloma Venereum/microbiology , Rectal Diseases/microbiology , Adolescent , Adult , Aged , Canada , Chlamydia Infections/diagnosis , Chlamydia Infections/epidemiology , Cross-Sectional Studies , Genital Diseases, Male/diagnosis , Genital Diseases, Male/epidemiology , Humans , Lymphogranuloma Venereum/diagnosis , Lymphogranuloma Venereum/epidemiology , Male , Middle Aged , Rectal Diseases/diagnosis , Rectal Diseases/epidemiology , Risk Factors , Young AdultABSTRACT
Zinc was found to have profoundly different effects upon the infection of McCoy cells (mouse fibroblasts) by two strains of Chlamydia trachomatis dependent upon the time and concentration of zinc exposure. Radiolabeled zinc-65 became McCoy cell-associated in a manner independent of incubation temperature, but highly dependent on incubation time and zinc concentration. This effect was maximal after 30 to 60 minutes of incubation. Correspondingly, incubation of a chlamydia inoculant with McCoy cells and supplemental zinc (10(-5) to 10(-4) M) for 1 h was associated with significantly (approximately twofold) more binding of the chlamydia to the McCoy cells compared with control media (8 X 10(-6) M Zn). More prolonged incubation of the chlamydia and McCoy cells with supplemental zinc was associated with significantly fewer chlamydia inclusions. Concentrations of 5 X 10(-4) M zinc or higher were also found to be toxic to the McCoy cells after 48 h of incubation. Brief exposure to supplemental zinc may augment infection of cells by chlamydia: however, more prolonged exposure to the same concentrations of zinc lessens cellular infection by chlamydia.