Cases reported "Lymphogranuloma Venereum"

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1/45. lymphogranuloma venereum presenting as a rectovaginal fistula.

    lymphogranuloma venereum (LGV) is a rare form of the sexually transmitted disease caused by chlamydia trachomatis. In the united states, there are fewer than 350 cases per year. In a review of the world's literature, there has not been a case reported in the last thirty years of a case of LGV presenting as a rectovaginal fistula. We present a case of an otherwise healthy American woman who presented with a rectovaginal fistula. Although uncommon, LGV does occur in developed countries and may have devastating tissue destruction if not recognized and treated before the tertiary stage. ( info)

2/45. Isolation in endothelial cell cultures of chlamydia trachomatis LGV (Serovar L2) from a lymph node of a patient with suspected cat scratch disease.

    An inguinal lymph node, removed from a 21-year-old Romanian man suspected of having cat scratch disease, was sent to our laboratory for Bartonella culture. Lymph node specimens were inoculated on blood-enriched agar and in an endothelial cell culture system using the centrifugation shell vial technique. bacteria were grown in cell monolayers and detected as positive with an anti-bartonella henselae rabbit serum. However, such bacteria were identified as chlamydia trachomatis biovar LGV serovar L2 by PCR sequencing techniques. Pathological examination of tissue biopsies was compatible with either lymphogranuloma venereum or cat scratch disease. The shell vial system is suitable for isolation of intracellular pathogens responsible for chronic lymphadenopathies, including C. trachomatis, Bartonella species, francisella tularensis, and mycobacteria. However, care should be taken when identifying Chlamydia spp. and Bartonella spp. using polyclonal antibodies, since species of both genera have common antigens which are responsible for cross-reactions. ( info)

3/45. Bilateral groove sign with penoscrotal elephantiasis.

    lymphogranuloma venereum (LGV) is a sexually transmitted disease of the lymph channels caused by chlamydia trachomatis. Esthiomene, a rare late manifestation of LGV, is a primary infection affecting the lymphatics of scrotum, penis, or vulva. The male genitalia are affected less commonly by esthiomene, but we report a male patient who presented with inguinal syndrome, penoscrotal elephantiasis, along with enlargement of femoral lymph nodes. ( info)

4/45. Unusual presentation of early lymphogranuloma venereum in an hiv-1 infected patient: effective treatment with 1 g azithromycin.

    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. ( info)

5/45. Inguinal bubo: problems in diagnosis.

    Two of the four patients with tropical venereal diseases underwent incision and drainage of the inguinal bubo resulting in discharging sinus before they were referred to the skin Clinic. Clinical diagnosis was made in all four but could not be confirmed. With appropriate therapy resolution was achieved without complications. The difficulties in arriving at and establishing the diagnosis are discussed. ( info)

6/45. Giant scrotal elephantiasis.

    How much can a man carry? Penoscrotal elephantiasis is a debilitating syndrome. This is a case report of a patient with giant genital elephantiasis secondary to long-standing lymphogranuloma venereum infection in ethiopia. Complete surgical resection of the pathologic tissue and penile reconstruction was undertaken with good cosmetic and functional results. ( info)

7/45. Mri findings in primary non-Hodgkin's lymphoma of the liver.

    Primary lymphoma of the liver is a very rare malignancy. Most often, these lesions consist of diffuse large B-cell non-Hodgkin's lymphoma that occurs mostly in immunodeficient patients. To prove the primary nature of a hepatic lesion, a systemic lymphoproliferative disease should be ruled out. Secondary liver involvement during Hodgkin's and non-Hodgkin's lymphoma is frequent. In advanced cases the incidence varies from 25% to 50%.The present case describes the MRI features of a primary lymphoma of the liver presenting as a solitary nodule. The primary lymphoma presents as a T2-hyperintense homogeneous nodule, with a signal intensity comparable with the signal intensity of the spleen. Signal intensity is comparable on in and out of phase imaging. The nodule is slightly T1-hypointense and doesn't show any arterial contrast uptake. In the late venous phase a slight increase in signal intensity is noted. Two and a half minutes after the administration of contrast agent, the lesion is iso-attenuating with the liver parenchyma.This case is rare because of the concomitant presence of heterozygous sickle cell anaemia and the presence of Gamna-Gandy bodies in the splenic parenchyma. It remains uncertain whether the presence of the Gamna-Gandy bodies is associated with the liver lymphoma or with the underlying sickle cell anaemia, or with a combination of both. ( info)

8/45. Saxophone penis revisited.

    Saxophone deformity of the penis is commonly secondary to diseases causing chronic lymphatic obstruction. lymphogranuloma venereum (LGV) is an important cause for this deformity. A case of LGV in genito-anorectal syndrome with a saxophone penis is reported along with the contrast-enhanced computed tomography (CECT) findings of anorectal involvement, and a probable hypothesis for this typical appearance of the penis. ( info)

9/45. The potential role of serology in diagnosing chronic lymphogranuloma venereum (LGV): a case of LGV mimicking Crohn's disease.

    We present the case of a 26 year old HIV positive homosexual man who was managed for suspected Crohn's disease for over 1 year before lymphogranuloma venereum (LGV) was clinically diagnosed. He had presented with constipation, secondary to acute haemorrhagic proctitis, and subsequently had two chlamydia negative rectal smears, using direct fluorescent antibody (DFA) chlamydia trachomatis staining. Positive chlamydial serology guided retrospective testing of an early rectal biopsy, which was found to have C trachomatis by polymerase chain reaction (Roche Cobas) and identified as LGV serovar L2 by the Sexually Transmitted bacteria Reference Laboratory (STBRL), health Protection Agency (HPA), Colindale, london. Chlamydial serology may have a role in identifying late stage LGV infection. Although no standardised test currently exists, consideration should be given to evaluating the role of chlamydial serology in establishing a diagnosis of LGV. ( info)

10/45. lymphogranuloma venereum in north america: case reports and an update for gastroenterologists.

    BACKGROUND & AIMS: In 2003, a sharp increase in cases of lymphogranuloma venereum (LGV) caused by chlamydia trachomatis in men who have sex with men was reported in europe and, recently, cases of LGV have been reported in north america. methods: We reviewed 3 cases of LGV proctitis recently diagnosed in canada. RESULTS: All 3 cases occurred in men who had sex with men; 2 of the patients had human immunodeficiency virus infection and 1 subsequently seroconverted. A delay in diagnosis occurred in all 3 patients: 2 patients were misdiagnosed initially with inflammatory bowel disease and 1 patient was treated as a case of non-LGV C trachomatis. CONCLUSIONS: Given the recent outbreak, gastroenterologists in europe and north america need to be familiar with the diagnosis and treatment of LGV because it mimics inflammatory bowel disease endoscopically and histologically. ( info)
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