LGV Flashcards
LGV is a sexually transmitted inf causes by?
Chlamydia trachomatis
LGV is also called as?
Nicholas -favre dis, tropical bubo/climatic bubo/lymphopathia venerea
Diagnosis of LGV is by?
serology or genotyping
LGV clinically manifests as ?
inguinal and anorectal syndromes
LGV spreads by which route?
hematogenous
In LGV peak incidence occurs in which age group?
15-40
LGV is contract by?
direct contact w infectious secretions - unprotected intercourse
Asymptomatic rectal inf&/ penile or oral inf is the source through?
sex toy sharing and fisting
which variant suggests more aggressive clinical course causing severe proctitis
L2c
In primary stage erythematous papules / small herpetiform ulcers appear how many days after inoculation?
3-30 days
Primary stage in LGV is of how many days?
3-30
In males at the primary stage of LGV lesions appear more on ?
coronal sulcus, prepuce or glans penis
In females the LGV lesions appear on ?
post wall of the vagina,vulva, or occasionally the cervix
In secondary stage the primary lesions appears where?
lymph node involvement and hematogenous dissemination
what are the signs and sxs in secondary stage of LGV?
fever, myalgia, dec apetite and vomiting, photosensitivity after bubo formation, meningoencephalitis, hepatosplenomegaly, arthralgia and iritis
lymphadenitis episodes in secondary stage resolves within how many days?
8-12 wks
In secondary stage depending on the mode of transmission which 2 syndromes are involved?
acute genital syndrome/ inguinal syndrome
In secondary stage nodal involvement on either side of the inguinal ligament which sign is pathognomonic?
groove sign
in secondary stage why there’s low abdominal/back pain in women that exacerbates upon lying supine and pelvic adhesions may ensue?
bc inguinal lymphadenitis the lymph drainage of the vagina and cervix is to the deep pelvic/retroperitoneal LN
in secondary stage which is the most common presentation in woman and homosexual men who practice anal sex?
acute anorectal syndrome (perirectal nodal involvement, acute hemorrhagic proctitis and systemic symptoms)
Tertiary stage of HSV is seen most often w ?
women w untreated anorectal syndrome
which finding is common in tertiary stage?
rectal strictures
what are other findings in tertiary stage of LGV ?
abscess, perineal sinuses, rectovaginal fistulae (watering can perineum) and lymphohemarroids, esthiomene (eating away) , ruptured deep LN causes infertility and frozen pelvis, urethral strictures , genital elephantiasis, saxophone penis
positive test on ___is considered diagnostic of LGV
lymph node aspirate
which is the earliest diagnostic test in LGV?
Frei test
which is the preferred test for LGV?
PCR-based assays
On histopathologic examination of HSV primary lesions reveal?
nonspecific ulceration, granulation tissue, endothelial swelling
Biopsy of the affected LN reveals?
granulomatous inflammation
What are the DDx of LGV?
Chancroid, granuloma inguinale
Ulcers in chancroid are?
larger and painful
in granuloma inguinale ulcers are?
abundant friable granulation tissue w/o associated lymphadenitis
what are the complication of LGV?
HIV,hep C , reactive arthritis in HLA-B27
what is first line treatment for LGV ?
oral doxycycline 100mg BID for 3 weeks
LGV infected pregnant and lactating women should be treated w?
azithromycin or erythromycin
doxycycline should be avoided in which week of pregnancy bc it inc risk of discoloration of teeth and bones
2nd & 3rd
