BACKGROUND There has been a rise in the number of cases diagnosed as lymphogranuloma venereum(LGV),caused by the transmission of Chlamydia trachomatis,specifi-cally serotypes L1,L2,and L3,mostly in men who have sex wi...BACKGROUND There has been a rise in the number of cases diagnosed as lymphogranuloma venereum(LGV),caused by the transmission of Chlamydia trachomatis,specifi-cally serotypes L1,L2,and L3,mostly in men who have sex with men(MSM).LGV can clinically manifest as rectal discomfort,bleeding,and mucoid discharge mimicking inflammatory bowel disease(IBD).Therefore,the role of a wholesome collection of patient history along with gaining patient trust and ease in reporting different elements of their life—whether social or sexual history-could greatly guide physician’s investigations leading to timely and more efficient diagnosis.CASE SUMMARY A 38-year-old male presenting with symptoms of rectal bleeding,mucoid dis-charge,and abdominal pain during the past month.Initial treatment for hemo-rrhoids given at an outpatient clinic did not improve the patient’s complaints warranting further examinations,whereby endoscopy revealed the presence of mucosal edema and ulcerations in the rectosigmoid area rendering IBD a plau-sible diagnosis theoretically,but practically refuted due to the negative biopsy results,and positive result of nucleic acid amplification testing of the rectal swab sample for Chlamydia trachomatis.The latter results are in accordance with the diagnosis of LGV proctosigmoiditis.Accordingly,medical therapy with doxycy-cline was instituted,which yielded a notable symptomatic relief,and an education on safe sexual practices.INTRODUCTION Chlamydia trachomatis is a gram-negative bacterium with 15 different serotypes that can be categorized based on their resulting infection:Trachoma,anogenital infection,and lymphogranuloma venereum(LGV).LGV is sexually transmitted disease mostly by oral or anal sex due to the contraction of serotypes L1,L2,and L3 of this bacterium with a rising number of cases in homosexual males who engage in sexual activity[1,2].Moreover,there has been an evident link between patients diagnosed with LGV and a positive history of human immunodeficiency virus[3].Diagnosing a patient with LGV can be challenging due to the unpredictable and varied nature of clinical symptoms[1].Its most common presentations consisting of rectal pain,hematochezia,tenesmus,or mucous discharge can closely mimic those of inflam-matory bowel disease(IBD),similarly for the severe inflammatory changes found in rectal biopsy results contributing to the struggle in forming differential diagnosis[2,4,5].The latter hence marks the importance of detailed and wholesome collection of the patient’s history to aid physicians in giving greater consideration to LGV as a differential diagnosis.For this,we herein depict the case of a 38 years old male patient who was diagnosed with LGV after revisiting the patient’s sexual history.展开更多
There has been an increasing prevalence of lymphogranuloma venereum(LGV) or Chlamydia trachomatis(C.trachomatis) cases among the men who have sex with men(MSM) population,particularly in Europe and North America.These...There has been an increasing prevalence of lymphogranuloma venereum(LGV) or Chlamydia trachomatis(C.trachomatis) cases among the men who have sex with men(MSM) population,particularly in Europe and North America.These cases may present with an incomplete or undisclosed history and proctosigmoiditis without characteristic adenopathy syndrome.During the initial evaluation and colonoscopy,there is a strong clinical and endoscopic suspicion of inflammatory bowel disease(IBD) by virtue of presentation and endoscopic and histological findings.The diagnosis of IBD is subsequently modified to LGV proctosigmoiditis when one or more of the following transpire:(1) there is failure of response to IBD therapy;(2) additional components of history(MSM/travel) may be identified;(3) return of initially performed Chlamydia antibody test is positive;and(4) response to antibiotics effective against Chlamydia.We describe three such cases initially suspectedto be an inflammatory bowel disease and subsequently identified as C.trachomatis proctosigmoiditis.展开更多
文摘BACKGROUND There has been a rise in the number of cases diagnosed as lymphogranuloma venereum(LGV),caused by the transmission of Chlamydia trachomatis,specifi-cally serotypes L1,L2,and L3,mostly in men who have sex with men(MSM).LGV can clinically manifest as rectal discomfort,bleeding,and mucoid discharge mimicking inflammatory bowel disease(IBD).Therefore,the role of a wholesome collection of patient history along with gaining patient trust and ease in reporting different elements of their life—whether social or sexual history-could greatly guide physician’s investigations leading to timely and more efficient diagnosis.CASE SUMMARY A 38-year-old male presenting with symptoms of rectal bleeding,mucoid dis-charge,and abdominal pain during the past month.Initial treatment for hemo-rrhoids given at an outpatient clinic did not improve the patient’s complaints warranting further examinations,whereby endoscopy revealed the presence of mucosal edema and ulcerations in the rectosigmoid area rendering IBD a plau-sible diagnosis theoretically,but practically refuted due to the negative biopsy results,and positive result of nucleic acid amplification testing of the rectal swab sample for Chlamydia trachomatis.The latter results are in accordance with the diagnosis of LGV proctosigmoiditis.Accordingly,medical therapy with doxycy-cline was instituted,which yielded a notable symptomatic relief,and an education on safe sexual practices.INTRODUCTION Chlamydia trachomatis is a gram-negative bacterium with 15 different serotypes that can be categorized based on their resulting infection:Trachoma,anogenital infection,and lymphogranuloma venereum(LGV).LGV is sexually transmitted disease mostly by oral or anal sex due to the contraction of serotypes L1,L2,and L3 of this bacterium with a rising number of cases in homosexual males who engage in sexual activity[1,2].Moreover,there has been an evident link between patients diagnosed with LGV and a positive history of human immunodeficiency virus[3].Diagnosing a patient with LGV can be challenging due to the unpredictable and varied nature of clinical symptoms[1].Its most common presentations consisting of rectal pain,hematochezia,tenesmus,or mucous discharge can closely mimic those of inflam-matory bowel disease(IBD),similarly for the severe inflammatory changes found in rectal biopsy results contributing to the struggle in forming differential diagnosis[2,4,5].The latter hence marks the importance of detailed and wholesome collection of the patient’s history to aid physicians in giving greater consideration to LGV as a differential diagnosis.For this,we herein depict the case of a 38 years old male patient who was diagnosed with LGV after revisiting the patient’s sexual history.
文摘There has been an increasing prevalence of lymphogranuloma venereum(LGV) or Chlamydia trachomatis(C.trachomatis) cases among the men who have sex with men(MSM) population,particularly in Europe and North America.These cases may present with an incomplete or undisclosed history and proctosigmoiditis without characteristic adenopathy syndrome.During the initial evaluation and colonoscopy,there is a strong clinical and endoscopic suspicion of inflammatory bowel disease(IBD) by virtue of presentation and endoscopic and histological findings.The diagnosis of IBD is subsequently modified to LGV proctosigmoiditis when one or more of the following transpire:(1) there is failure of response to IBD therapy;(2) additional components of history(MSM/travel) may be identified;(3) return of initially performed Chlamydia antibody test is positive;and(4) response to antibiotics effective against Chlamydia.We describe three such cases initially suspectedto be an inflammatory bowel disease and subsequently identified as C.trachomatis proctosigmoiditis.
