Unusual presentation of early lymphogranuloma venereum in an HIV-1 infected patient: effective treatment with 1 g azithromycin.

Abstract

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.

• Authors: R F Nieuwenhuis, J M Ossewaarde, W I van der Meijden, H A M Neumann
• Journal: Sexually transmitted infections (Sex Transm Infect) Vol. 79 Issue 6 Pg. 453-5 (Dec 2003) ISSN: 1368-4973 [Print] England
• PMID: 14663119 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Bacterial Agents
• Azithromycin

Topics

• AIDS-Related Opportunistic Infections (complications)
• Adult
• Anti-Bacterial Agents (administration & dosage)
• Anus Diseases (drug therapy, microbiology)
• Azithromycin (administration & dosage)
• Chlamydia trachomatis (isolation & purification)
• Groin
• HIV Infections (complications)
• HIV-1
• Humans
• Lymphadenitis (microbiology)
• Lymphogranuloma Venereum (complications, drug therapy)
• Male
• Ulcer (drug therapy, microbiology)