Sharp rise in venereal lymphogranulomatosis in industrialized countries.

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Jojo Ming (Image: Portail VIH/Sida du Québec)

Lymphogranuloma venereum (LGV) is a sexually transmitted infection (STI) caused by certain serovars of the bacterium Chlamydia trachomatis. This infection primarily affects the lymphatic system, leading to the inflammation of lymph nodes and other tissues.

Causes and Transmission:

Lymphogranuloma venereum is caused by Chlamydia trachomatis, a bacterium that can infect the genital, urinary, and gastrointestinal tracts. LGV is mainly associated with certain serovars of Chlamydia trachomatis, specifically L1, L2, and L3. The infection is most commonly transmitted through sexual contact, including vaginal, anal, and oral sex. Unprotected sexual activity, multiple sexual partners, and engaging in high-risk sexual behaviors increase the risk of LGV transmission.

Symptoms:

The symptoms of LGV can vary depending on the stage of the infection. The disease typically progresses through three stages:

  1. Primary Stage:
    • Small, painless genital ulcers or sores appear.
    • These may go unnoticed or may be mistaken for other genital infections.
  2. Secondary Stage:
    • Swelling and inflammation of the lymph nodes in the affected region.
    • Pain and tenderness in the groin.
    • Fever, chills, and malaise.
    • Rectal symptoms if the infection is acquired through anal sex, including pain, discharge, and bleeding.
  3. Tertiary Stage:
    • Complications may arise months or years later if the infection is left untreated.
    • Severe damage to the lymphatic system, leading to conditions such as fistulas, strictures, and abscesses.

Diagnosis:

Diagnosing LGV involves a combination of clinical assessment, laboratory tests, and patient history. Healthcare providers may inquire about the patient’s sexual history and conduct a physical examination. Laboratory tests, such as PCR (polymerase chain reaction) tests and serological tests, can be performed to detect the presence of Chlamydia trachomatis and confirm the diagnosis.

Treatment:

The treatment of lymphogranuloma venereum typically involves the use of antibiotics. The choice of antibiotics and the duration of the treatment may vary based on the stage of the infection and the severity of symptoms. Commonly prescribed antibiotics include doxycycline and azithromycin. It is crucial for individuals diagnosed with LGV to complete the entire course of antibiotics as prescribed by their healthcare provider, even if symptoms improve before the medication is finished.

Prevention:

Preventing the transmission of LGV involves practicing safe sex and taking precautions to reduce the risk of STIs. Key preventive measures include:

  • Consistent and correct use of condoms during sexual activity.
  • Regular testing for STIs, especially for individuals with multiple sexual partners.
  • Open communication with sexual partners about STI status and safe sex practices.

Public Health Implications:

The phrase « Forte remontée du lymphogranulomatose vénérien dans les pays industrialisés » suggests a significant increase in the prevalence of lymphogranuloma venereum in industrialized countries. Such a surge in cases could have several implications for public health:

  1. Increased Awareness and Education:
    • Public health campaigns and educational initiatives may be necessary to raise awareness about LGV, its symptoms, and preventive measures.
  2. Enhanced Screening Programs:
    • Healthcare systems may need to strengthen screening programs to detect and diagnose LGV early, allowing for prompt treatment and prevention of complications.
  3. Improved Access to Healthcare:
    • Efforts to enhance access to healthcare services, particularly for individuals at higher risk of STIs, can contribute to early detection and treatment of LGV.
  4. Collaboration and Surveillance:
    • Collaboration between public health agencies, healthcare providers, and community organizations is essential for effective surveillance and control of STIs.
  5. Research and Development:
    • Investment in research for improved diagnostics, treatments, and prevention strategies can be crucial in addressing the growing challenge of LGV.