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Lymphogranuloma Venereum - Coggle Diagram
Lymphogranuloma Venereum
Risk Factors
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Unusual sexual penetration (anal, oral, fisting, etc)
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Differential Diagnosis
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Secondary
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Malignancy-rectal carcinoma, lymphoma
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Primary
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Infectious proctitis−including gonorrhea, CMV, HSV, amoebiesis
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Definition
Ulcerative sexually transmitted infection of the genital area that is transmittable by vaginal, oral, or anal sex.
Etiology
A gram-negative bacteria Chlamydia trachomatis, especially serovars L1, L2, and L3,
Prognosis
Fair if antibiotic treatment, given early.
Treatment
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Medication
2nd line: Azithromycin 1 to 1,5 g once weekly for 3 weeks
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Complication
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Stenosis of the rectum, possibly leading to ‘lymphorrhoids’ (haemorrhoid‐like swellings of obstructed rectal lymphatic tissue).
Prevention
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Avoid having multisexual partner, and homosexual
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To exclude reinfections, retesting by nuclear amplification tests(NAAT) (also including HIV, syphilis, and hepatitis C) during a follow up test 3 months after an LGV diagnosis should be offered.
Education
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Patients risk of contracting other sexually transmitted infections like HIV, hepatitis, syphilis, chancroid, gonorrhea, etc.
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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 (MSM) should recognize that LGV is prevalent in these populations and should know the signs and symptoms of LGV
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Pathophysiology
Chlamydia trachomatis serovars extend from the primary infection site to the regional lymph nodes and cause a lymphoproliferative reaction, facilitated by binding of Chlamydia trachomatis to the epithelial cells. Binding occurs via heparin sulfate receptors.
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