Unusual presentation of early lymphogranuloma venereum in an HIV-1 infected patient: effective treatment with 1 g azithromycin
Unusual presentation of early lymphogranuloma venereum in an HIV-1 infected patient: effective treatment with 1 g azithromycin
复制标题
DOI：
10.1136/sti.79.6.453
复制
发表时间：
2003-12-01
影响因子：
3.6
通讯作者：
Neumann, HAM
中科院分区：
文献类型：
--
作者：
Nieuwenhuis, RF;Ossewaarde, JM;Neumann, HAM
在西方世界，性病淋巴肉芽肿 (LGV) 的发病率较低。早期 LGV 的特点是无痛性丘疹或小溃疡后出现腺鼠疫。我们报告了一名白人双性恋男性，他患有疼痛性肛周溃疡、腹股沟淋巴结炎，并伴有人类免疫缺陷病毒 1 (HIV-1) 感染。经过聚合酶链反应并通过限制性片段长度多态性对主要外膜蛋白进行基因分型后，确定沙眼衣原体血清型 L2 为致病菌。单剂量1g阿奇霉素治疗有效。该病例说明早期 LGV 可能与其他生殖器溃疡病相似，例如生殖器疱疹或软下疳，尤其是在 HIV 感染患者中。在西方世界，LGV 仍必须纳入伴有或不伴有性获得性溃疡的腺鼠疫的鉴别诊断中。
The incidence of lymphogranuloma venereum ( LGV) is low in the western world. Early LGV is characterised by bubonic disease following a painless papule or small ulcer. We report a white bisexual male who presented with a painful perianal ulcer, inguinal lymphadenitis, and concomitant infection with human immunodeficiency virus 1 ( HIV- 1). Chlamydia trachomatis serovar L2 was identified as the cause after polymerase chain reaction and genotyping the major outer membrane protein by restricted fragment length polymorphism. Treatment with a single dose of 1 g azithromycin was effective. This case illustrates that early LGV may mimic other genital ulcer diseases, such as genital herpes or chancroid, especially in HIV infected patients. In the western world, LGV must still be included in the differential diagnosis of bubonic disease with or without sexually acquired ulcers.