Cases reported "Proctitis"

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1/11. 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.
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ranking = 1
keywords = lymphogranuloma, lymphogranuloma venereum, venereum
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2/11. 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.
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ranking = 0.23324675141896
keywords = lymphogranuloma, lymphogranuloma venereum, venereum
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3/11. Supralevator abscess due to chronic rectal lymphogranuloma venereum.

    lymphogranuloma venereum (LGV) usually manifests as an inguinal syndrome, but it can also cause an anorectal syndrome that is difficult to diagnose because of its similarity to other disorders, the lack of easily available specific laboratory tests, and an assumption that it occurs only in women or homosexual men. LGV proctitis is often mild, but chronic cases can have serious complications. We describe a heterosexual Vietnamese man with a rectal stricture and supralevator abscess due to LGV proctitis whose presentation mimicked that of rectal cancer.
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ranking = 0.80831168785474
keywords = lymphogranuloma, lymphogranuloma venereum, venereum
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4/11. Hemorrhagic proctitis due to lymphogranuloma venereum serogroup L2. diagnosis by fluorescent monoclonal antibody.

    Definitive diagnosis of lymphogranuloma venereum is impeded by difficulty in culturing the causative agent and by serologic cross-reactivity between chlamydia trachomatis L1, L2, and L3, which can cause the disease, and the many other serotypes of C. trachomatis, which do not. In a 23-year-old man with massive rectal bleeding, an exudative rectal ulcer, and inguinal lymphadenopathy, serologic findings were compatible with a recent lymphogranuloma venereum infection, but stains and cultures of lymph-node aspirates were negative, and biopsy specimens of the rectum and lymph nodes showed only nonspecific inflammatory changes. A diagnosis of lymphogranuloma venereum was made when intracellular organisms and inclusion bodies were demonstrated in rectal submucosal tissue by fluorescein-tagged monoclonal antibodies directed against both chlamydial group antigens and L2 serotype antigen. This technique was of particular value in this patient because it specifically identified an unusual cause of severe gastrointestinal bleeding.
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ranking = 1.4
keywords = lymphogranuloma, lymphogranuloma venereum, venereum
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5/11. Radiographic findings of infectious proctitis in homosexual men.

    Homosexual men are known to have an increased incidence of sexually transmitted proctitis. A knowledge of the pathogenesis and the radiographic appearance of these processes has resulted in earlier diagnosis and more rapid institution of appropriate therapy. While gonococcus (neisseria gonorrhoeae) and lymphogranuloma venereum (usually Chlamydia) have long been considered the common etiologies of proctitis in this population, other organisms, such as herpes, mycoplasma, and entamoeba have been implicated and could give an identical radiographic and clinical pattern. Diffuse narrowing and ulceration limited to the rectum was seen in five affected homosexual men recently studied at Northwestern Memorial Hospital, chicago.
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ranking = 0.2
keywords = lymphogranuloma, lymphogranuloma venereum, venereum
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6/11. chlamydia trachomatis proctitis.

    One hundreds seventy-one homosexual men, 96 of whom had symptoms suggestive of proctitis and 75 of whom had no such symptoms, were consecutively enrolled in a study of the prevalence, clinical spectrum, and histopathology of chlamydia trachomatis rectal infections. C. trachomatis was isolated from the rectums of 14 men. Three of the isolates, which had lymphogranuloma venereum (LGV) immunotypes, were recovered from three men with symptoms and signs of severe proctitis, two of whom had granulomatous inflammation that was observed at rectal biopsy and was initially suggestive of Crohn's disease. Eleven isolates, which had non-LGV immunotypes, were obtained from eight symptomatic and three asymptomatic men, all of whom had fecal leukocytes and mild abnormalities of the mucosa present at sigmoidoscopy, usually with mild nongranulomatous inflammatory changes that were seen on rectal biopsy. These observations suggest that the presence of LGV immunotypes of C. trachomatis in the rectum is associated with severe acute proctitis that mimics Crohn's disease of the rectum, whereas the non-LGV immunotypes are associated with a mild proctitis with or without symptoms.
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ranking = 0.2
keywords = lymphogranuloma, lymphogranuloma venereum, venereum
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7/11. lymphogranuloma venereum and acute ulcerative proctitis.

    The lymphogranuloma venereum (LGV) L2 serotype of chlamydia trachomatis has been isolated from the rectums of three homosexual men with acute, primary ulcerative proctitis that responded to appropriate anti-chlamydial therapy. LGV is still present in the urban united states and must be considered in cases of acute ulcerative proctitis.
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ranking = 0.23324675141896
keywords = lymphogranuloma, lymphogranuloma venereum, venereum
(Clic here for more details about this article)

8/11. Rectal biopsy in early lymphogranuloma venereum proctitis.

    Two cases of early lymphogranuloma venereum (LGV) proctitis are presented, with discussion of the histopathologic findings of the rectal biopsy specimens. Emphasis is placed on the need to recognize this condition in the early stage of inflammation, before the development of stricture, so that complete cure can be effected.
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ranking = 0.041558439273701
keywords = venereum
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9/11. Chronic proctitis in male homosexuals due to lymphogranuloma venereum.

    lymphogranuloma venereum (LGV) has been infrequently reported as a cause of proctitis. We report 3 homosexual men with chronic ulcerative proctitis which was cured after therapy for LGV. The complement fixation test for LGV was positive in 2 of the 3 patients.
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ranking = 0.80831168785474
keywords = lymphogranuloma, lymphogranuloma venereum, venereum
(Clic here for more details about this article)

10/11. infection with chlamydia trachomatis lymphogranuloma venereum serovar L1 in homosexual men with proctitis: molecular analysis of an unusual case cluster.

    Among 767 rectal isolates of chlamydia trachomatis obtained from men over the period 1981-1991, 7 were found to be a rare lymphogranuloma venereum serovar, L1. These isolates were from rectal specimens taken from five male patients in 1982-1983. Six of the seven isolates were available for dna sequencing studies. All six of these isolates shared the same dna sequence in the major outer membrane protein (MOMP) gene variable domains and had different MOMP sequences than did the prototype L1, L2, and L3 strains, suggesting a point source outbreak. All five patients infected with serovar L-1 were homosexual men who had symptomatic proctitis characterized by rectal pain, discharge, tenesmus, abnormalities seen on anoscopy, and leukocytes seen on gram stains of rectal specimens. We conclude that an unrecognized point source outbreak of the rare chlamydial L1 serovar occurred among homosexual men in Seattle in 1982-1983, and that the clinical manifestations of L1 infection may be less severe than those of L2 infections.
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ranking = 1
keywords = lymphogranuloma, lymphogranuloma venereum, venereum
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