LGV is a serovar (L1, L2, L3) of Chlamydia trachomatis and can cause invasive disease
The incidence of LGV has increased in the developed world in the last 10 years predominantly in men who have sex with men. Ongoing outbreaks have occurred in European, North American and Australasian capital cities mostly amongst HIV positive MSM. A proportion of cases have also been identified in HIV positive men without rectal symptoms and HIV negative men with rectal symptoms. Presence of other STIs and hepatitis C has been associated with LGV diagnosis.
Two clinical syndromes are seen:
the ano-rectal syndrome presenting with usually symptomatic proctitis – most often seen in HIV positive MSM
the genito-inguinal syndrome presenting with an initial small genital ulcer followed by inguinal lymphadenopathy and, if untreated, bubo formation – more often seen in heterosexual transmission in developing countries.
These guidelines are based on review of current literature, current recommendations of the United States Centres for Disease Control and Prevention, World Health Organization, the British Association for Sexual Health and HIV, Australian national and state guidelines, and expert opinion. Local antimicrobial sensitivities are reflected in these recommendations.
They are written primarily for use by Clinic 275 in the setting of a specialist Sexual Health Clinic, with on-site laboratory facilities. Some flexibility is required in applying them to other clinical settings.
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