LGV mimicking IBD in Austin


Original Title: Lam_184cc.jpg
Depicted in this 2007 photograph, CDC microbiologist Dr Cheng-Yen Chen, was shown preparing a pyrosequencing experiment in order to differentiate between Chlamydia trachomatis L-serovars responsible for lymphogranuloma venereum (LGV), and other chlamydial serovars. Organisms of the same genus are further subdivided into serovars, or serotypes, which group these organisms based upon their constituent intracellular antigenic profiles.Dr. Chen is a National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) staff member, who works inside the center’s Laboratory Reference and Research Branch (LRRB). Image credit: CDC/ Hsi Liu, Ph.D., MBA, James Gathany



Lymphogranuloma venereum (LGV) is a sexually transmitted disease caused by a variant of Chlamydia trachomatis different from the variant causing urethritis in men and cervicitis in women. In contrast, it causes genital ulcer in the first stage, while the second stage can be swollen, tender, and enlarged lymph nodes or proctocolitis with rectal discharge. It is endemic in tropical areas of the world. However, it has been increasingly reported in developed countries since 2003. There has been outbreaks reported in Western Europe and North America, primarily in men who have sex with men (MSM) who are also HIV-infected, mostly presenting as proctitis. 

LGV is not a reportable disease in Texas. However, the last known case of it in this state was in 2013. Beginning last year, several MSM with HIV have been diagnosed with it here in Austin. Providers here in Austin should be aware of this. LGV can present as proctitis and can get mistaken for Inflammatory Bowel Disease and not get appropriately treated causing complications for the patient such as fistulae, strictures, and infertility; as well as spread of the infection itself as well as of HIV.

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