Lymphogranuloma venereum physical examination: Difference between revisions
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===Tertiary LGV=== | ===Tertiary LGV=== | ||
*Patients present with [[perirectal]] [[fistulas]] and/or [[strictures]] | *Patients present with [[perirectal]] [[fistulas]] and/or [[strictures]] | ||
*Proctoscopy may reveal ulcerative [[proctitis]] | *Patients presenting at this stage are predominantly female | ||
*Proctoscopy may reveal ulcerative [[proctitis]]<ref name="pmid10449269">{{cite journal| author=Lynch CM, Felder TL, Schwandt RA, Shashy RG| title=Lymphogranuloma venereum presenting as a rectovaginal fistula. | journal=Infect Dis Obstet Gynecol | year= 1999 | volume= 7 | issue= 4 | pages= 199-201 | pmid=10449269 | doi=10.1155/S1064744999000344 | pmc=PMC1784745 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10449269 }} </ref> | |||
*[[Elephantiasis]] of gentials | *[[Elephantiasis]] of gentials | ||
*Ulceration and thickening of the [[vulva]] in females | *Ulceration and thickening of the [[vulva]] in females | ||
Revision as of 16:54, 24 February 2016
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Lymphogranuloma venereum Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Nate Michalak, B.A.
Overview
Physcial Examination
Primary LGV
- Patients presenting at first stage of LGV usually have a small, nontender papule or ulcer.[1]
- Common locations in males:
- Common locations in females:
- Posterior vaginal wall
- Posterior cervix
- Fourchette
- Vulva
- Due to lesion location on each sex, more males present at this stage than females.[1]
Secondary LGV
- Patients present with tender, swollen lymph nodes, typically unilateral, known as buboes.
- Enlarged inguinal and/or femoral lymph nodes occur after primary lesion of anterior genital area (anterior vulva, penis, or urethra).
- Enlarged iliac and/or perirectal lymph nodes occure after primary lesion of posterior genital area (posterior vulva, vagina, or anus).
- Inguinal inflammation more common in men while anorectal lymphadenopathy more common in women
- 20% of patients develop "Groove sign": enlarged inguinal and femoral lymph nodes separated by the inguinal ligament.[2]
- Buboes may present as indurated abscesses or ruptured, draining sinuses.[3]
Tertiary LGV
- Patients present with perirectal fistulas and/or strictures
- Patients presenting at this stage are predominantly female
- Proctoscopy may reveal ulcerative proctitis[4]
- Elephantiasis of gentials
- Ulceration and thickening of the vulva in females
- Penile and scrotal edema termed "saxophone penis"[5]
Gallery
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Lymphogranuloma venereum: is caused by the invasive serovars L1, L2, or L3 of Chlamydia trachomatis. This young adult experienced the acute onset of tender, enlarged lymph nodes in both groins.
References
- ↑ 1.0 1.1 Ceovic R, Gulin SJ (2015). "Lymphogranuloma venereum: diagnostic and treatment challenges". Infect Drug Resist. 8: 39–47. doi:10.2147/IDR.S57540. PMC 4381887. PMID 25870512.
- ↑ Roest RW, van der Meijden WI, European Branch of the International Union against Sexually Transmitted Infection and the European Office of the World Health Organization (2001). "European guideline for the management of tropical genito-ulcerative diseases". Int J STD AIDS. 12 Suppl 3: 78–83. PMID 11589803.
- ↑ Mabey, D (2002). "Lymphogranuloma venereum". Sexually Transmitted Infections. 78 (2): 90–92. doi:10.1136/sti.78.2.90. ISSN 1368-4973.
- ↑ Lynch CM, Felder TL, Schwandt RA, Shashy RG (1999). "Lymphogranuloma venereum presenting as a rectovaginal fistula". Infect Dis Obstet Gynecol. 7 (4): 199–201. doi:10.1155/S1064744999000344. PMC 1784745. PMID 10449269.
- ↑ Koley S, Mandal RK (2013). "Saxophone penis after unilateral inguinal bubo of lymphogranuloma venereum". Indian J Sex Transm Dis. 34 (2): 149–51. doi:10.4103/0253-7184.120575. PMC 3841672. PMID 24339471.