To infections transmitted due to sexual contact, is
characterized by lesions of the femoral, inguinal, iliac, and deep pelvic lymph nodes.
Often chlamydia lymphogranuloma common in tropical or subtropical regions of South and Central America, Southeast and South Asia. Sporadic cases are found in Russia, but due to migration, outbreaks of such infections is not excluded.
Chlamydia trachomatis is the causative agent of the disease, infection which is carried through sexual contact with an infected person. Sometimes lymphogranuloma venereum can occur due to close contact with contaminated objects. Microtrauma of the skin and mucous membranes may be susceptible to defeat infection.
Lymphogranuloma venereum is spread by lymphogenous, resulting in possible occurrence of perlinganit, thrombocythemia, perilymphatic. In the lymph nodes develops an inflammatory process, which is complicated by necrosis of endothelial cells and later on the periphery of the formation of polymorphic leukocytes.
Although the pathological process is localized directly in the lymph nodes, the agent can still spread disseminated through the different systems and organs, including the CNS. Not always immune mechanisms provide the necessary reaction, so often the disease is detected after a long period of time in case of late manifestations.
Chlamydial infection is characterized by a latent period of 314 days, and in some cases up to 2 months.
The symptoms of chlamydial lymphogranuloma depending on the period of the disease manifest themselves in different ways. There is usually headache, low-grade fever, joint or muscle pain, the appearance of grouped vesicles or the surface of Paull in place of the introduction of the pathogen (skin or mucosa).
Manifestation of primary items men and women accompanied by various symptoms
- women have a localization of the primary foci in the place small or large lip, near the external opening of the urethra, on the cervix or vaginal wall
- in men, symptoms are localized in the region of the scrotum, in the area of the coronal sulcus, on the body or head of the penis, the outer or inner layer of the foreskin.
In both sexes, the localization can be in the area of the anal region. Usually primary items may disappear after a few days, so that they remain invisible. And later, after 26 weeks, and sometimes longer, revealed a unilateral lesion of the lymphatic system nodes. That is, the detected lymph nodes are of large size, exhibited by soreness, and also have the spot welded inguinal lymph nodes, hypertrophy of the skin in the affected area or redness. At the same time, the inguinal syndrome is complicated by fever, urticaria, weight loss and appetite, lesions of the meninges, arthralgia and others. Lymph nodes abscess to form adhesions, deformity, fistula, stricture, and this, in turn, carries with it complications such as obstruction of the rectum, elephantiasis of the genitals and other things.
In medical practice was rare manifestations in the form of follicular conjunctivitis, lesions of the nasopharynx as a result of inflammation of certain lymph nodes.
Found the concept genitourinary syndrome manifesting itself after 13 years of the disease characterized by hyperplasia of lymphoid tissue of the perianal area and intestines, and proctocolectomy.
Chlamydia lymphogranuloma venereum is determined by analysis of anamnesis in the case of a patient in endemic areas, on the basis of the clinical picture and laboratory tests.
In particular, using
- culture method based on research biopsy of a lymph node or infected tissue (the accuracy of the method not more than 50%)
- the complement fixation gives a positive result only after several weeks (24) after infection. But it is worth to remember about cross-reactions with antigens of other possible types of chlamydia
- the study of the haemogram monocytosis, leukocytosis, increased ESR, eosinophilia, increased svarochnoe the contents of immunoglobulins G, M, And
- PCR reaction radioisotope of precipitation
- the reaction of the Frey, as an auxiliary analysis of the sample inside the skin with 0.1 ml of antigen, which shows the result after 4872 hours, but it should be remembered and false-positive test result.
Should further examine the patient for other diseases transmitted through sexual contact. It is also worth to differentiate chlamydial from limfogranulema
, inguinal granuloma,
malignant tumors, deep mycosis, tuberculosis of the inguinal lymph nodes.
Treatment of venereal lymphogranuloma aimed at the destruction of the virus, Chlamydia trachomatis, and timely warning of destruction of tissue or the appearance of scarring.
Treatment is azeotropy in nature and based on doxycyline inside not less than 21 days or similar substitute erythromycin. Symptomatic therapy based on the enzyme preparations, vitamins PP, A, b, angioprotectors and analgesics. When there is the presence of the characteristic buboes, it is necessary to apply the cut nodes and their subsequent drainage. Treatment of pregnant women or in lactation based on the erythromycin.
The combination of the infection with HIV, treatment can be lengthy, it will depend on the characteristic symptoms. To determine that the patient is healthy, will help special results of tests with a negative index, or usual clinical symptoms. Sometimes, after the disease is necessary to conduct a series of operations of plastic areas due to lesions of the internal organs.