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3.
Hautarzt ; 71(4): 275-283, 2020 Apr.
Artículo en Alemán | MEDLINE | ID: mdl-32025745

RESUMEN

BACKGROUND: Sexually transmitted infections (STIs) in the anorectal region are disproportionally detected in risk populations such as men who have sex with men (MSM). However, due to changes in sexual behaviour they are increasingly diagnosed in heterosexual individuals. Due to the recent implementation of oral HIV pre-exposure prophylaxis together with lack of condom use, a further rise in STIs is expected. OBJECTIVES: This review addresses epidemiology, clinical picture, diagnostic pitfalls and current therapy guidelines of "classical" bacterial STIs involving the anorectum. CONCLUSIONS: STI manifestations in the anal region are frequently nonspecific or asymptomatic so that the diagnosis may be missed. In an endoscopic examination of the rectum, they can even mimic inflammatory bowel disease or malignancy. Therefore, knowledge of possible symptoms of bacterial STIs in this area is helpful for early diagnosis. Coinfections with other STIs are common and should prompt a search of other pathogens including HIV and hepatitis B/C.


Asunto(s)
Enfermedades del Ano/diagnóstico , Coinfección/diagnóstico , Enfermedades del Recto/diagnóstico , Conducta Sexual , Enfermedades de Transmisión Sexual , Sexo Inseguro , Enfermedades del Ano/epidemiología , Enfermedades del Ano/terapia , Infecciones por Chlamydia/diagnóstico , Infecciones por Chlamydia/epidemiología , Infecciones por Chlamydia/terapia , Coinfección/epidemiología , Femenino , Gonorrea/diagnóstico , Gonorrea/epidemiología , Gonorrea/terapia , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Heterosexualidad , Homosexualidad Masculina , Humanos , Linfogranuloma Venéreo/diagnóstico , Linfogranuloma Venéreo/epidemiología , Linfogranuloma Venéreo/terapia , Masculino , Enfermedades del Recto/epidemiología , Enfermedades del Recto/terapia , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/terapia , Sífilis/diagnóstico , Sífilis/epidemiología , Sífilis/terapia
5.
Emerg Infect Dis ; 25(11): 2112-2114, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31625852

RESUMEN

Orolabial lymphogranuloma venereum was diagnosed for a man in Michigan, USA, who had sex with men, some infected with HIV. High index of suspicion for lymphogranuloma venereum led to accurate diagnosis, successful therapy, and description of an L2b variant with a unique genetic mutation.


Asunto(s)
Enfermedades de los Labios/diagnóstico , Enfermedades de los Labios/microbiología , Linfogranuloma Venéreo/diagnóstico , Linfogranuloma Venéreo/microbiología , Adulto , Coinfección , Infecciones por VIH , Homosexualidad Masculina , Humanos , Linfogranuloma Venéreo/transmisión , Masculino , Úlcera/microbiología
6.
J Eur Acad Dermatol Venereol ; 33(10): 1821-1828, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31243838

RESUMEN

New or important issues in this updated version of the 2013 European guideline on the management of lymphogranuloma venereum (LGV): EPIDEMIOLOGY: Lymphogranuloma venereum continues to be endemic among European men who have sex with men (MSM) since 2003. Lymphogranuloma venereum infections in heterosexuals are extremely rare in Europe, and there is no evidence of transmission of LGV in the European heterosexual population. AETIOLOGY AND TRANSMISSION: Chlamydia trachomatis serovars/genovars L2b and L2 are the causative strains in the majority of cases in Europe. CLINICAL FEATURES: Among MSM, about 25% of the anorectal LGV infections are asymptomatic. Genital infections among MSM are rare; the ratio of genital vs. anorectal LGV infections is 1 in 15. DIAGNOSIS: To diagnose LGV, a sample tested C. trachomatis positive with a commercial nucleic acid amplification test (NAAT) platform should be confirmed with an LGV discriminatory NAAT. TREATMENT: Doxycycline 100 mg twice a day orally for 21 days is the recommended treatment for LGV. This same treatment is recommended also in asymptomatic patients and contacts of LGV patients. If another regimen is used, a test of cure (TOC) must be performed.


Asunto(s)
Antibacterianos/uso terapéutico , Linfogranuloma Venéreo/diagnóstico , Linfogranuloma Venéreo/tratamiento farmacológico , Linfogranuloma Venéreo/terapia , Trazado de Contacto , Notificación de Enfermedades , Europa (Continente) , Humanos , Linfogranuloma Venéreo/etiología , Educación del Paciente como Asunto
8.
Int J STD AIDS ; 30(5): 515-518, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30714874

RESUMEN

An epidemic of lymphogranuloma venereum among men who have sex with men (MSM) has persisted in Australia for over a decade and virtually all diagnoses are made from rectal samples. We discuss two cases of human immunodeficiency virus-negative MSM who presented with a penile ulcer. The diagnosis can be made by ensuring a swab of any such ulcer is tested for Chlamydia trachomatis.


Asunto(s)
Chlamydia trachomatis/aislamiento & purificación , Homosexualidad Masculina , Linfogranuloma Venéreo/diagnóstico , Adulto , Canal Anal/microbiología , Antibacterianos/uso terapéutico , Doxiciclina/uso terapéutico , Seronegatividad para VIH , Humanos , Linfogranuloma Venéreo/tratamiento farmacológico , Linfogranuloma Venéreo/microbiología , Masculino , Resultado del Tratamiento , Úlcera/diagnóstico , Úlcera/tratamiento farmacológico , Úlcera/microbiología
9.
Sex Transm Dis ; 46(2): e14-e17, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30278027

RESUMEN

Using Chlamydia trachomatis anorectal specimens routinely tested for lymphogranuloma venereum (LGV) (2008-2011) and samples of archived specimens tested for LGV (2012-2015), we observed increased LGV positivity among men who have sex with men attending NYC Sexual Health Clinics. Using clinical data, we determined predictors of anorectal LGV that may guide clinical management.


Asunto(s)
Homosexualidad Masculina/estadística & datos numéricos , Linfogranuloma Venéreo/epidemiología , Enfermedades del Recto/microbiología , Salud Sexual , Adulto , Instituciones de Atención Ambulatoria/estadística & datos numéricos , Chlamydia trachomatis , Humanos , Linfogranuloma Venéreo/diagnóstico , Masculino , Ciudad de Nueva York/epidemiología , Enfermedades del Recto/epidemiología , Factores de Riesgo
10.
Sex Transm Infect ; 95(3): 169-170, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-30554142

RESUMEN

Oropharyngeal lymphogranuloma venereum (LGV) is an uncommon presentation and mainly consists of either asymptomatic infections or enlarged cervical lymphadenopathy. According to cross-sectional studies, the prevalence of pharyngeal LGV among men who have sex with men (MSM) seems to be very low. Tissue tropism could explain the difference between rectal and oral mucosa infection frequencies. This paper reports the singular case of an oral ulcer caused by LGV in an MSM who had also an asymptomatic rectal infection. Given the increasing number of cases of LGV, unusual presentations such as oral ulceration may be seen more frequently.


Asunto(s)
Infecciones por VIH , Linfogranuloma Venéreo/diagnóstico , Enfermedades de la Lengua/diagnóstico , Úlcera/diagnóstico , Adulto , Antibacterianos/uso terapéutico , Diagnóstico Diferencial , Doxiciclina/uso terapéutico , Humanos , Linfogranuloma Venéreo/complicaciones , Linfogranuloma Venéreo/tratamiento farmacológico , Masculino , Enfermedades de la Lengua/complicaciones , Enfermedades de la Lengua/tratamiento farmacológico , Úlcera/complicaciones , Úlcera/tratamiento farmacológico , Carga Viral
11.
Euro Surveill ; 23(43)2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-30376912

RESUMEN

From 1 January to 30 June 2018, 11 cases of Lymphogranuloma venereum (LGV; all preserved samples (n = 4) genovar L2b) were identified at the Genitourinary Clinic (GUC), Mater Dei Hospital, Msida, Malta. All cases were diagnosed in men who have sex with men (MSM); six participated in three group-sex parties. Here, we describe the outbreak and risk factors associated with LGV diagnoses in MSM in Malta in 2018.


Asunto(s)
Chlamydia trachomatis/aislamiento & purificación , Coinfección/diagnóstico , Brotes de Enfermedades , Homosexualidad Masculina , Linfogranuloma Venéreo/diagnóstico , Adulto , Chlamydia trachomatis/genética , Trazado de Contacto , Gonorrea/diagnóstico , Infecciones por VIH/diagnóstico , Humanos , Linfogranuloma Venéreo/epidemiología , Masculino , Malta/epidemiología , Técnicas de Amplificación de Ácido Nucleico , Factores de Riesgo
14.
Rev Esp Enferm Dig ; 110(10): 676-677, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-30168342

RESUMEN

Lymphogranuloma venereum (LV) is a sexually transmitted disease that may have atypical clinical manifestations mimicking tumors or inflammatory conditions, which renders its diagnosis difficult. LV requires both a clinical and endoscopic diagnosis before early treatment may be administered, and should be included as a differential diagnosis for individuals with risk factors.


Asunto(s)
Linfogranuloma Venéreo/diagnóstico , Neoplasias del Recto/diagnóstico , Adulto , Diagnóstico Diferencial , Humanos , Masculino
15.
Int J STD AIDS ; 29(12): 1215-1224, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-29973128

RESUMEN

The objective of this article is to describe the epidemiology of lymphogranuloma venereum (LGV) and non-LGV Chlamydia trachomatis anorectal infections in France and to examine the characteristics of the affected populations via a voluntary sentinel surveillance system for LGV between 2010 and 2015. Anorectal samples positive for C. trachomatis (CT) were sent by the participating laboratories to the National Reference Center for CT for LGV identification. Biological and clinical data were collected by biologists and clinicians. There were 1740 LGV episodes and 2248 non-LGV episodes. Continuous monitoring highlighted a sharp increase in the number of LGV and non-LGV anorectal infections, which were 2.3-fold and 6.5-fold, respectively. Most of the infections occurred in men who have sex with men. LGV patients were older than non-LGV patients and were more frequently human immunodeficiency virus (HIV)-positive compared to non-LGV patients. Anorectal LGV was significantly associated with residence in Paris, HIV co-infection, concurrent syphilis and bloody anal discharge. Undocumented patient characteristics were strongly associated with anorectal LGV. The anorectal LGV epidemic is poorly controlled in France. Early detection and prompt treatment of patients and their sexual partners are required to prevent transmission in the context of pre-exposure prophylaxis (PrEP) for HIV infection.


Asunto(s)
Infecciones por Chlamydia/diagnóstico , Chlamydia trachomatis/aislamiento & purificación , Infecciones por VIH/complicaciones , Linfogranuloma Venéreo/diagnóstico , Enfermedades del Recto/microbiología , Adolescente , Adulto , Distribución por Edad , Anciano , Infecciones por Chlamydia/epidemiología , Francia/epidemiología , Heterosexualidad , Homosexualidad Masculina , Humanos , Linfogranuloma Venéreo/epidemiología , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , Enfermedades del Recto/epidemiología , Vigilancia de Guardia , Parejas Sexuales , Adulto Joven
16.
Lancet Infect Dis ; 18(12): e399-e407, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-29983342

RESUMEN

Genital Chlamydia trachomatis infection is the most commonly diagnosed sexually transmitted infection. Trachoma is caused by ocular infection with C trachomatis and is the leading infectious cause of blindness worldwide. New serological assays for C trachomatis could facilitate improved understanding of C trachomatis epidemiology and prevention. C trachomatis serology offers a means of investigating the incidence of chlamydia infection and might be developed as a biomarker of scarring sequelae, such as pelvic inflammatory disease. Therefore, serological assays have potential as epidemiological tools to quantify unmet need, inform service planning, evaluate interventions including screening and treatment, and to assess new vaccine candidates. However, questions about the performance characteristics and interpretation of C trachomatis serological assays remain, which must be addressed to advance development within this field. In this Personal View, we explore the available information about C trachomatis serology and propose several priority actions. These actions involve development of target product profiles to guide assay selection and assessment across multiple applications and populations, establishment of a serum bank to facilitate assay development and evaluation, and development of technical and statistical methods for assay evaluation and analysis of serological findings. The field of C trachomatis serology will benefit from collaboration across the public health community to align technological developments with their potential applications.


Asunto(s)
Chlamydia trachomatis/aislamiento & purificación , Linfogranuloma Venéreo/diagnóstico , Linfogranuloma Venéreo/epidemiología , Pruebas Serológicas/métodos , Tracoma/diagnóstico , Tracoma/epidemiología , Interpretación Estadística de Datos , Humanos , Incidencia , Linfogranuloma Venéreo/inmunología , Linfogranuloma Venéreo/microbiología , Pruebas Serológicas/normas , Tracoma/inmunología , Tracoma/microbiología
18.
Medicina (B Aires) ; 78(3): 207-210, 2018.
Artículo en Español | MEDLINE | ID: mdl-29940550

RESUMEN

From 2003 to date there has been a rising number of reports from developed countries on cases of lymphogranuloma venereum with anorectal localization in HIV-infected men who have sex with men. This localization differs from the classical inguinal abscesses which are typical of the disease in the tropics. The objective of this work is to document the presence of anorectal lymphogranuloma venereum in Buenos Aires and to describe its varied clinical manifestations. In the context of a systematic survey of rectal chlamydial infection, in just one trimester, eight cases of lymphogranuloma venereum caused by Chlamydia trachomatis biovar LGV were identified in HIV-infected men who have sex with men. The most frequent anorectal manifestations were pus, tenesmus, rectal urgency, and mucous or haemopurulent discharge. The proctitis was mostly mild or moderate and, in some cases, it was accompanied by perianal lesions. Given the great polymorphism and unspecificity of the clinical manifestations of the disease, we warn on the presence of this form of rectal lymphogranuloma venereum in our setting. If Chlamydia trachomatis is detected, it should be genotyped, not only for the correct diagnosis and treatment but also for epidemiological surveillance. Where genotyping is not available, the disease must be considered as caused by the LGV biovar and treated accordingly.


Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/diagnóstico , Chlamydia trachomatis/genética , Linfogranuloma Venéreo/diagnóstico , Proctitis/diagnóstico , Minorías Sexuales y de Género , Infecciones Oportunistas Relacionadas con el SIDA/microbiología , Adulto , Humanos , Linfogranuloma Venéreo/microbiología , Masculino , Polimorfismo Genético , Proctitis/microbiología , Estudios Prospectivos
19.
Rev Esp Enferm Dig ; 110(6): 410, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-29722270

RESUMEN

Lymphogranuloma venereum (LGV) is a condition caused by invasive serovars of Chlamydia trachomatis. The classical inguinal presentation that is characterized by the development of transient genital ulcer(s) and inguinal or femoral lymphadenopathy has decreased in our environment. At present, infection by this bacterium has emerged as an important cause of proctitis and proctocolitis in men who have sex with other men. We report the case of a homosexual man with acute proctitis that was complicated by a perirectal abscess secondary to a Chlamydia trachomatis infection.


Asunto(s)
Absceso/diagnóstico , Linfogranuloma Venéreo/diagnóstico , Proctitis/microbiología , Absceso/complicaciones , Diagnóstico Diferencial , Humanos , Linfogranuloma Venéreo/complicaciones , Masculino , Persona de Mediana Edad , Proctitis/diagnóstico
20.
Ugeskr Laeger ; 180(20)2018 May 14.
Artículo en Danés | MEDLINE | ID: mdl-29798754

RESUMEN

Oculo-genital chlamydia caused by Chlamydia trachomatis is the most frequent sexually transmitted infection. The number of laboratory verified cases increases steadily in Denmark. This is due to an increased testing activity but also increased positivity rates. Men show substantially lower test rates than women albeit higher positivity rates and seem to constitute an important reservoir for a continued high prevalence of chlamydia. Screening and treatment of especially younger sexually active individuals, not at least men, is vital in controlling the disease.


Asunto(s)
Infecciones por Chlamydia , Linfogranuloma Venéreo , Adolescente , Adulto , Infecciones por Chlamydia/diagnóstico , Infecciones por Chlamydia/tratamiento farmacológico , Infecciones por Chlamydia/epidemiología , Chlamydia trachomatis/aislamiento & purificación , Dinamarca/epidemiología , Femenino , Humanos , Linfogranuloma Venéreo/diagnóstico , Linfogranuloma Venéreo/tratamiento farmacológico , Linfogranuloma Venéreo/epidemiología , Linfogranuloma Venéreo/patología , Masculino , Adulto Joven
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