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LIMFOGRANULOMA VENEREUM (LVG) - Coggle Diagram
LIMFOGRANULOMA VENEREUM (LVG)
Defenisi
a sexually transmitted disease caused by Chlamydia trachomatis
and is characterized by suppurative inguinal adenitis.
DD pembengkakan regio inguinal
Cellulitis of the lower extremities
Venereal infections - Syphilis, chancroid, herpes simplex virus infection, lymphogranuloma venereum
Lymphomas
Metastatic melanomas from lower extremity primary site
Squamous cell carcinomas from genital primary site
Patofisiologi
Perlekatan partikel awal yang infeksius pada sel hospes
Masuknya partikel ke sel hospes
Perubahan morfologi menjadi Reticular Body yang berada di dalam intraseluler dan mengalami replikasi di dalam vakuola, letaknya melekat pada inti sel hospes
Vakuola yang pecah menyebabkan perubahan morfologi dari Reticular Body menjadi Elementary Body
Pelepasan partikel yang infeksius
CMD LGV
Clinical Findiings
Primer
begins as a small, painless papule or pustule that may erode to form a small, asymptomatic herpetiform ulcer that usually heals rapidly without scarring.
often goes unnoticed by the patient.
Sekunder
painful regional lymphadenopathy (usually in the inguinal and/or femoral lymph nodes).
fever, chills, myalgias, and malaise
Tersier
proctatitis
Bloody purulent discharge
Rectal pain
Tenesmus
Pemeriksaan Penunjang
Tes Fiksasi Komplemen Tes
Darah Lengkap
Tes Mikroimunofluoresen
Nucleic Acid Amplification Test (NAAT)
Anatomi Inguinal
Major lymph nodes of the pelvis
Illiac lymph node
Internal Illiac lymph node
Eksternal Illiac lymph node
Sacral lymph nodes
Common iliac lymph node
Main Group
Superficial
Inferior : inferior of the saphenous opening -> receive from lower leg
Superolateral : side of sahphenous -> receive from side of buttocks
Superomedial : middle of saphenous -> receive from perineum and genital
Deep
Faktor Resiko
Highest incidence of LGV is in the sexually active population between 15 and 40 years
There is a significant association between HIV-infected patients and LGV
Men typically present with the acute form of the disease whereas
Women often present when they develop complications from later stages of the disease
Etiologi
Chlamydia Trachomatis
serovar L: L1, L2, and L3) → systemic disease by infecting monocytes and macrophages and then invading submucosal sites and regional lymph nodes
Tatalaksana
Doxycycline 100 mg PO bid for 21 d
Erythromycin base 500 mg PO qid for 21 d
Komplikasi
necrosis and rupture of the lymph nodes
anogenital fibrosis and strictures
anal fistulae
Elephantiasis of the genital organs
Systemic complications like pneumonia and hepatitis
Edukasi
Patients should receive education regarding the signs and symptoms of early recognition of LGV.
Patients should learn about the need to use condoms or other protective measures while engaging in sexual activity.
Sexual partners of patients who tested positive or probably positive should also be tested, and treatment initiated if necessary.
Men who have sex with men should recognize that LGV is prevalent in these populations and should know the signs and symptoms of LGV.
DD Inguinal Lymphadenopathy
Chanchroid
Herpes Simplex
Hernia
