The venereal lymphogranulome or disease of Durand-Nicolas-Favre is a Infection sexually transmissible due to an infection by the Sérovar S (or Biovar) invasive L1, L2, or L3 of Chlamydia trachomatis . The disease was discovered by Wallace in 1833 then by Durand, Nicolas, and Favre in 1913. It affects especially the lymphatic Système.

In the United States, in Europe, in Australia and in the major part of Asia and South America, the LGV is generally regarded as a rare disease. It is endemic in Africa, in India, in certain areas of the South-East Asia and the Antilles.

Epidemiology

Its transmission is frequent and its frightening consequences. It reaches the young subjects and represents a great cause of sterility at the woman. This infection can pass unperceived to the man, but especially to the woman from where facility of transmission. It is frequent STI in tropical area.

Signs and symptoms

inguinal syndrome named after the formation off buboes gold Abscess be in the face mask (inguinal) area where draining lymph nodes are located. The rectal syndrome arises rectal yew the infection takes place via the mucosa (through anal sex) and is mainly characterized by Proctocolitis symptoms. Rare The pharyngeal syndrome is, starts after infection off pharyngeal tissue and bubo' S in the neck area edge occur. -->

Primary education stage

After an incubation from 3 to 30 days in the continuations of a sexual relation, appear painless erosive papules on the genitals, the sphere ano-rectal or pharyngée during a few days. At the woman, these lesions are generally vaginal and require an examination with the speculum to be detected. but to skirt in this primary training course. Rarely C women note has primary infection, because the initial ulceration where the organism penetrates the mucosal to bush-hammer vaginal are located out off sight in the wall. Also in men fewer than 1/3 off those infected note the first signs off LGV. Primary This training course heals in has few days.

Erythema nodosum occurs in 10% off boxes. -->

Secondary stage

Two to six weeks after the contaminating sexual relation, appear adenopathies on the areas draining the bodies touched at the time of the primary education stage. In the majority of the cases, these adenopathy are inguinales or femoral.

At the time of ano-rectal contamination, one notes a Rectite associated with rectal pains (Ténesme), diarrheal flows mucopurulants and abdominal colics.

This phase is accompanied by fever, shivers and joint pains.

The evolution lets appear an adherence of fabrics cutaneous to the suppurated adenopathies which are fistulisent there to leave sourdre pus.

Tertiary stage

The genital fabrics are sclerosed and a fibrosis is trained as well as a lymphœdème lower extremities. These lesions are final. Over the race off the disease, lymph nodes enlarge, enlarged nodes are called buboes, and become painful At first (which may occur in any infection off the same areas ace well). The next most common thing is ignition, thinning and fixing off the overlying skin. Lastly in the progression are Necrosis, fluctuating and suppurative lymph nodes, Abscess be, fistulas, strictures, and sine leaflets all may occur. During the infection and when it subsidies and healing takes place, fibrosis may occur. This edge result in varying dismantle off lymphatic obstruction, chronic Edema, and Stricture S. These late training courses characterized by fibrosis and edema are also known ace the third training course off LGV and permanent are mainly. -->

General complications

Sometimes one notes in the continuations of a contamination by this chlamydiae of the complications a such knotty erythema, and a Méningo-encéphalite.

Forecast

Long-term complications

Elephantiasis gold Esthiomene, which is the dramatic end-result off lymphatic obstruction, which may occur because off the strictures themselves, but fistulas. This is usually seen yew females, may ulcerate and often occurs 1-20 years after primary infection. Fistulas off, goal not limited to, the penis, will urethra, vagina, uterus, gold rectum. Also, surrounding edema often occurs. Rectal gold other strictures and scarring. Systemic spread may occur, possible results are arthritis, pneumonitis, hepatitis, but perihepatitis. -->

Diagnosis

Diagnosis usually is made serologically (through complement fixing) and by exclusion off other causes off inguinal lymphadenopathy gold Genital Ulcer S. Serologic testing has has sensitivity 80% after 2 off weeks. Serologic testing may not Be specific for serotype (has nap cross-country race reactivity with other chlamydia species) and edge suggest LGV from other forms because off to their difference in dilution, 1:64 more likely to Be LGV and lower than 1:16 is likely to Be other chlamydia forms (emedicine). For idenification off serotypes, culture is often used. Culture is difficult. Requiring has special media, cycloheximide-treated McCoy gold HeLa concealments, and yields are still only 30-50%. DFA, but direct fluorescent antibody test, PCR off likely infected areas and pus, are also sometimes used. Sensitive DFA test for the serovar L-type off C trachomatis is the most and specific test, goal is not readily available. Yew polymerase chain reaction (PCR) tests one infected material are positive, subsequent restriction endonuclease pattern analysis off the amplified outer membrane protein has embarrassment edge Be gives to given the genotype. Recently has fast realtime PCR (Taqman analysis) has been developed to diagnosis LGV. Feasible With this method year accurate diagnosis is within has day. Standard It has been noted that one off testing my not Be thorough enough. -->

Complementary recommendations

Urethra L cervical gold Chlamydia L infection. After has positive culture for chalamydia, clinical suspicion should Be confirmed with testing to distinguish serotype. Antibiotic treatment should Be started yew they had sexual patient contact with the during the 30 days preceding onset off symptoms in the patient.

Patients with has sexually transmited disease need to Be tested for other STD' S. Antibiotics are not without risks and prophylaxtic broad antibiotic coverage is not recommended. -->

Disease prevention and treatment

The prevention passes by the use of the condom.

The treatment is a antibiothérapie by cycline S (doxycycline, tétracycline) throughout one 3 week minimal among patients of more than eight years. (Érythromycine in the child or in the event of allergy to the cyclines)

The sclerosing lesions are treated surgically or by mechanical dilation. The ganglionic abscesses are put flat, and drained by aspiration with the needle.

External references and bonds

1998 At http://wonder.cdc.gov/wonder/prevguid/p0000480/p0000480.asp#head007005000000000 notes that this has not been modified since 1998, and may Be out off date.

• Article one eMedicine.com Last Updated: 16 October 2004
• Centers for Disease Control and Prevention. Proctitis, proctocolitis, and enteritis. Sexually transmitted diseases treatment guidelines. MMWR Recomm Reference marks 2002 10 May; 51 (RR-6): 66-7.
• Fitzpatrick' S color atlas and synopsis off clinical dermatology 5th ED. Wolf and Al
• Rosen T. Brown: Genital ulcers - and evaluation treatment. Dermatology Covering joint. 1998; 16: 673.
• Nederlands tijdschrift voor geneeskunde. vol. 148, No 51 (18 December 2004): 2544-6.
• Dermatology. vol. 209, No 3 (2004): 230-2.
• MMWR. Morbidity and mortality weekly carryforward. vol. 53, No 42 (29 October 2004): 985-8.
• International newspaper off STD & AIDS. vol. 13, No 6 (2002 Jun): 427-9.
• http://www.essti.org/
• Emerging Infectious Diseases vol. 11 No 7 July 2005: 1090-2. * Emerging Infectious Diseases vol. 11 No 8 August 2005: 1311-2.
• Emerging Infectious Diseases vol. 11 No 11 November 2005: 1787-8.
• Clinical Infectious Diseases vol. 42 No 2 January 15 2006: 186-94. -->

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