Lymphogranuloma venereum proctosigmoiditis is a mimicker of inflammatory bowel disease

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.

Lymphogranuloma venereum caused by Chlamydia trachomatis serovar L3:a case report

Lymphogranuloma venereum （LGV） is a systemic sexually transmitted disease caused by Chlamydia trachomatis （C. trachomatis） L1, L2 and L3, the organism gains entrance through skin breaks and abrasions and travels via the lymphatics to multiply within mononuclear phagocytes in regional lymph nodes, The clinical presentation of LGV depends on the sex of the patient, mode of sexual contact （e.g. vaginal or anal sex） and the stage of the disease. LGV is diagnosed in men up to 6 times more frequently than in women, but the infected women are more likely developed to late stage. LGV is rare in China, however the incidence was increasing in recent years. In this paper we diagnosed a case of LGV, and confirmed this case was caused by L3 serovar of C. trachomatis by using genotype test.

性病性淋巴肉芽肿合并皮肤鳞状细胞癌一例

患者男，53岁，冠状沟增生物2年，腹股沟包块红肿、疼痛、破溃2月余。体检：双侧腹股沟淋巴结红肿约2cmX1．5em，质硬，触痛，右侧腹股沟肿大淋巴结中心波动，其上见多处破溃及黄白色脓性分泌物流出，如喷水壶状。多个肿大或破溃淋巴结被腹股沟韧带分隔，形成明显的沟槽征。冠状沟两侧可见1cmX2em不规则疣状增生，质硬，表面角化。龟头系带处红肿，有波动，并有破溃伴黄白色脓液渗出，右侧阴囊肿胀。龟头系带处分泌物及左右侧腹股沟穿刺液多次真菌培养阴性，细菌培养阴性，抗酸染色阴性，沙眼衣原体培养初次为阴性，衣原体内源性质粒PCR检测阳性，ompl-限制性片段长度多态性（RFLP）分型为L3型。Western印迹示血清沙眼衣原体主要外膜蛋白（MOMP）抗体阳性，多形外膜蛋白H（PmpH）抗体〉1：800，衣原体多代培养阳性。右腹股沟疣状增生处活检示皮肤高分化鳞状细胞癌。诊断：性病性淋巴肉芽肿合并皮肤鳞状细胞癌。

性病性淋巴肉芽肿的研究进展

性病性淋巴肉芽肿是由L型沙眼衣原体引起的一种经典的性传播疾病。临床上以生殖器溃疡、腹股沟淋巴结病或生殖器肛门直肠综合征为主要特征，病程慢性。中国仅有散发病例报道。近年在欧美国家的男男同性性行为者中有性病性淋巴肉芽肿暴发流行，其流行菌株主要是L2b型沙眼衣原体。男男同性性行为者人群中的性病性淋巴肉芽肿多为有症状的直肠炎，有多性伴或高危性行为，常合并HIV感染、其他性传播疾病和血源性疾病。分子生物学检测技术在性病性淋巴肉芽肿的诊断与鉴定中发挥着重要的作用。

男男性行为人群性病性淋巴肉芽肿的流行状况及其研究进展

性病性淋巴肉芽肿是性传播疾病之一。20世纪,此病在绝大多数发达国家已经得到有效的控制。然而,2003年底以来,此病在欧美等发达国家重新流行,并且在男男性行为人群中不断发生散发、爆发或流行。在男男性行为人群中,其流行特征表现为以沙眼衣原体L2型感染为主,主要发生在艾滋病病毒(HIV)感染者,且有特征性的直肠炎临床表现。目前性病淋巴肉芽肿的实验室诊断以实时聚合酶链反应(PCR)为主要手段,强力霉素仍作为治疗的首选药物。