title: Epidemic Lymphogranuloma venereum during epidemics of crack cocaine use and HIV infection in the Bahamas.
abstract: BACKGROUND
  Since the early 1980s, the Bahamas has experienced sequential epidemics of freebase/crack cocaine use, genital ulcer-inguinal adenopathy disease (GUD), and heterosexual HIV infection.
  
  
  OBJECTIVE
  To prospectively define the etiology of GUD in patients at the Princess Margaret Hospital during outbreaks of crack cocaine use, GUD, and HIV infection in the Bahamas.
  
  
  METHODS
  In Nassau, 47 consecutive patients with GUD underwent serologic testing for syphilis and for infections with HIV, herpes simplex virus type 2 (HSV-2), and Chlamydia trachomatis. Genital ulcer specimens were tested by culture and/or polymerase chain reaction (PCR) assay for Haemophilus ducreyi; by PCR and/or antigen assay for HSV; and by PCR for C trachomatis. Lymph node aspirates were tested by PCR for C trachomatis and H ducreyi.
  
  
  RESULTS
  Twenty patients (43%) had HIV infection; eight had lymphogranuloma venereum (LGV), confirmed by PCR detection of C trachomatis sequences consistent with the L2 serovar; and nine others had possible LGV, on the basis of serum microimmunofluorescent C trachomatis antibody titers > or =256. Inguinal lymphadenopathy or bubo was present in 15 of 17 patients, who thus met the laboratory criteria for definite or possible LGV, and in 7 of 30 who did not meet such laboratory criteria (P < 0.001). Thirteen patients had confirmed genital herpes, seven had confirmed chancroid, and four had probable or possible primary syphilis.
  
  
  CONCLUSIONS
  The epidemics in the Bahamas of crack use, heterosexual HIV infection, and GUD apparently included epidemic transmission of LGV.
authors: University of Washington Division of Infectious Diseases, Seattle, USA.
authors: J Eric
authors: JE
authors: Bauwens
authors: Herbert
authors: H
authors: Orlander
authors: M Perry
authors: MP
authors: Gomez
authors: Mary
authors: M
authors: Lampe
authors: Stephen
authors: S
authors: Morse
authors: Walter E
authors: WE
authors: Stamm
authors: Richard
authors: R
authors: Cone
authors: Rhoda
authors: R
authors: Ashley
authors: Paul
authors: P
authors: Swenson
authors: King K
authors: KK
authors: Holmes
mesh_terms: D000328:Adult; D001444:Bahamas / Q000453:epidemiology; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D019970:Cocaine-Related Disorders / Q000150:complications / Q000453:epidemiology*; D017931:DNA Primers; D004196:Disease Outbreaks; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology*; D015497:HIV-1 / Q000302:isolation & purification; D015498:HIV-2; D006191:Haemophilus ducreyi / Q000302:isolation & purification; D018258:Herpesvirus 2, Human / Q000302:isolation & purification; D006801:Humans; D008219:Lymphogranuloma Venereum / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology / Q000821:virology; D008297:Male; D016133:Polymerase Chain Reaction; D011446:Prospective Studies
chemical_list: D017931:DNA Primers