title: Lymphogranuloma Venereum 2015: Clinical Presentation, Diagnosis, and Treatment.
abstract: Lymphogranuloma venereum (LGV) has emerged as an important cause of proctitis and proctocolitis in men who have sex with men; classical inguinal presentation is now increasingly uncommon. We report summary findings of an extensive literature review on LGV clinical presentation, diagnosis, and treatment that form the evidence base for the 2015 Centers for Disease Control and Prevention treatment guidelines for sexually transmitted diseases. Proctitis and proctocolitis are now the most commonly reported clinical manifestations of LGV, with symptoms resembling those of inflammatory bowel disease. Newer molecular tests to confirm LGV infection are sensitive and specific, but are generally restricted to research laboratory or public health settings. Doxycycline (100 mg twice daily for 21 days) remains the treatment of choice for LGV. Patients with rectal chlamydial infection and signs or symptoms of proctitis should be tested for LGV, or if confirmatory testing is not available, should be treated empirically with a recommended regimen to cover LGV infection.
authors.affiliation: Department of Anthropology and Division of Infectious Diseases, Washington University, St Louis, Missouri.
authors.forename: Bradley P
authors.initials: BP
authors.lastname: Stoner
authors.affiliation: San Francisco Department of Public Health Division of Infectious Diseases, University of California, San Francisco.
authors.forename: Stephanie E
authors.initials: SE
authors.lastname: Cohen
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002487:Centers for Disease Control and Prevention, U.S.; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D004318:Doxycycline / Q000627:therapeutic use; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy; D018451:Homosexuality, Male; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000382:microbiology; D008219:Lymphogranuloma Venereum / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D008297:Male; D017410:Practice Guidelines as Topic; D011349:Proctitis / Q000382:microbiology; D014481:United States / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D004318:Doxycycline
keywords: LGV; diagnosis; proctitis; proctocolitis; treatment