RESUMO
We report an HIV-infected person who was treated for lymphogranuloma venereum cervical lymphadenopathy and proctitis in Croatia in 2014. Infection with a variant L2b genovar of Chlamydia trachomatis was detected in a cervical lymph node aspirate. A prolonged course of doxycycline was required to cure the infection.
Assuntos
Chlamydia trachomatis , Linfonodos/microbiologia , Linfogranuloma Venéreo/epidemiologia , Linfogranuloma Venéreo/microbiologia , Chlamydia trachomatis/classificação , Chlamydia trachomatis/genética , Coinfecção , Croácia/epidemiologia , Infecções por HIV , História do Século XXI , Humanos , Linfogranuloma Venéreo/história , MasculinoRESUMO
We describe a change in the molecular epidemiology of Chlamydia trachomatis strains involved in an outbreak of rectal lymphogranuloma venereum in France during January 2010-April 2015. Until 2012, the C. trachomatis L2b strain predominated; however, starting in 2013, most cases involved the L2 strain. We also identified 4 genetic L2b ompA variants.
Assuntos
Chlamydia trachomatis/classificação , Surtos de Doenças , Linfogranuloma Venéreo/epidemiologia , Linfogranuloma Venéreo/microbiologia , Proteínas da Membrana Bacteriana Externa/genética , Chlamydia trachomatis/genética , Coinfecção , França/epidemiologia , Variação Genética , Genótipo , Infecções por HIV , História do Século XXI , Homossexualidade Masculina , Humanos , Linfogranuloma Venéreo/história , Linfogranuloma Venéreo/transmissão , Masculino , Estudos RetrospectivosRESUMO
The lymphogranuloma venereum (LGV) outbreak described in the Netherlands in 2003, increased the interest in the genotyping of Chlamydia trachomatis. Although international surveillance programmes were implemented, these studies slowly decreased in the following years. Now data have revealed a new accumulation of LGV cases in those European countries with extended surveillance programmes. Between March 2009 and November 2011, a study was carried out to detect LGV cases in Madrid. The study was based on screening of C. trachomatis using commercial kits, followed by real-time pmpH-PCR discriminating LGV strains, and finally ompA gene was sequenced for phylogenetic reconstruction. Ninety-four LGV infections were identified. The number of cases increased from 10 to 30 and then to 54 during 2009-2011. Incidence of LGV was strongly associated with men who have sex with men; but in 2011, LGV cases were described in women and heterosexual men. Sixty-nine patients were also human immunodeficiency virus (HIV) positive, with detectable viral loads at the moment of LGV diagnosis, suggesting a high-risk of co-transmission. In fact, in four patients the diagnosis of HIV was simultaneous with LGV infection. The conventional treatment with doxycycline was prescribed in 75 patients, although in three patients the treatment failed. The sequencing of the ompA gene permitted identification of two independent transmission nodes. One constituted by 25 sequences identical to the L2b variant, and a second node including 37 sequences identical to L2. This epidemiological situation characterized by the co-circulation of two LGV variants has not been previously described, reinforcing the need for screening and genotyping of LGV strains.
Assuntos
Chlamydia trachomatis/classificação , Linfogranuloma Venéreo/epidemiologia , Linfogranuloma Venéreo/microbiologia , Adolescente , Adulto , Idoso , Proteínas da Membrana Bacteriana Externa/genética , Chlamydia trachomatis/genética , Chlamydia trachomatis/isolamento & purificação , Surtos de Doenças , Feminino , História do Século XXI , Humanos , Linfogranuloma Venéreo/diagnóstico , Linfogranuloma Venéreo/história , Masculino , Pessoa de Meia-Idade , Dados de Sequência Molecular , Filogenia , Espanha , Adulto JovemAssuntos
Linfogranuloma Venéreo/história , Doenças do Ânus/história , Elefantíase/história , Feminino , Doenças dos Genitais Femininos/história , Doenças dos Genitais Masculinos/história , História do Século XIX , História do Século XX , Humanos , Linfogranuloma Venéreo/complicações , Linfogranuloma Venéreo/diagnóstico , Masculino , Doenças Retais/história , Sífilis/históriaAssuntos
Linfogranuloma Venéreo/história , Feminino , França , Alemanha , História do Século XIX , História do Século XX , Humanos , Masculino , Estados UnidosRESUMO
One hundred patients with rectal lymphogranuloma venereum were treated at the University College Hospital, Jamaica. Patients were all of the lowest socio-economic group. Ninety per cent of patients were females. The generally accepted theory of spread of infection by lymphatics from vagina to rectum is refuted and the possibility of contiguous spread is suggested. The disease is chronic, progressing from proctocolitis to ano-rectal stricture. Secondary infection probably contributes to stricture formation. Early treatment of proctocolitis by broad spectrum antibiotics prevents stricture formation. Major operation is required only for the extensive stricture. In all cases restoration of sphincter function should be the aim. This has been achieved by an intra sphincteric proctectomy in many cases (AU)
Assuntos
Humanos , Criança , Adulto , Masculino , Feminino , Linfogranuloma Venéreo/diagnóstico , Linfogranuloma Venéreo/tratamento farmacológico , Linfogranuloma Venéreo/etiologia , Linfogranuloma Venéreo/história , Linfogranuloma Venéreo/patologia , Proctocolite/diagnóstico , Proctocolite/tratamento farmacológico , Proctocolite/etiologia , JamaicaRESUMO
A brief history of lymphogranuloma with special reference to rectal involvement is given. Experience in Jamaica in the treatment of 144 cases of rectal lymphogranuloma is reported. In cases of proctocolitis, patients can be relieved of rectal stricture only by its removal but symptoms may be relieved by more conservative treatment. Excision operations should be reserved for the severe cases. The prognosis of proctectomy with preservation of sphincter function should be guarded. The abdomino-end-anal operation of Dimitriu and Gregoresco has given promising results. (Summary)
