Lymphogranuloma venereum

Lymphogranuloma venereum is a sexually transmitted disease manifested by an ulcer. It occurs mainly in the tropics and subtropics (Asia, Africa, South America).

Etiology
Lymphogranuloma venereum is caused by Chlamydia trachomatis, which penetrates the damaged mucosa.

Clinical manifestation
The incubation period lasts approximately 14 days but can range from 2 to 30 days. Serology is used - a complement fixation reaction with a high titer of antibodies.
 * 1) stage - a small ulcer on the mucous membrane is formed, which is often overlooked.
 * 2) stage - swelling of the descending nodes, they gradually merge, colliquative necrosis occurs, and fistulas form. The discharge is purulent and during healing, scars form. General symptoms accompanied by a non-specific rash may be present.
 * 3) stage – arises as a consequence of a disorder of the lymphatic system - anogenital lymphedema (so-called esthiomene)

Differential diagnosis
It is necessary to distinguish other genital ulcers. A hard, painless ulcer is a symptom of syphilis, a soft ulcer of the chancroid. It is also necessary to distinguish Herpes simplex, etc.

Therapy
Doxycycline 200 mg/day and erythromycin 2 g/day are given p.o. for 21 days.

Course and prognosis
It is good after treatment.

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