This is the cause of lymphogranuloma venereum

Lymphogranuloma venereum is a type of sexually transmitted disease that mainly occurs in the genitals of men and women, causing blisters on the skin of the genitals. It is very harmful to the body and can be transmitted through sexual intercourse. It is usually caused by unclean sexual life or frequent changes of sexual partners.

Causes

The pathogen of lymphogranuloma venereum is three serotypes, L1, L2, and L3, among the 15 serotypes of Chlamydia trachomatis. Compared with other serotypes, L type is more invasive. It is mainly transmitted through sexual contact and occasionally through accidental transmission through contamination or experimentation. This disease was more common before and in the early days of liberation in our country. After 1991, sporadic cases were reported in some areas. As of 2001, several hundred cases were reported annually, but the reported cases were not confirmed by serological testing or culture.

Clinical manifestations

1. Incubation period

There is a history of unclean sexual intercourse, with an incubation period of 5 to 21 days.

2. Early symptoms

Initial sores often occur on the penis shaft, glans, coronal sulcus and foreskin of men, and on the vestibule, labia minora, vaginal opening and urethral opening of women. They are small blisters, papules, erosions and ulcers of 5 to 6 mm in size. They are usually single, sometimes several, with no obvious symptoms, do not heal for several days, and leave no scars after healing.

3. Mid-term symptoms

1 to 4 weeks after the initial sore appears, the male inguinal lymph nodes become swollen (bubo quaternum), painful, tender, adherent, fused, and the "groove sign" may be seen (the inguinal ligament separates the swollen lymph nodes up and down, and the skin appears grooved). After several weeks, the lymph nodes soften and rupture, discharging yellow serous fluid or bloody pus, forming multiple fistulas that resemble a "watering pot". They do not heal for several months and leave scars after healing. The first sores in women often occur in the lower part of the vagina, and flow back to the iliac and rectal lymph nodes, causing lymphadenitis, proctitis and perectectal inflammation in this area. Clinically, there may be blood in the stool, abdominal pain, diarrhea, tenesmus and low back pain, and the formation of perianal swelling, fistula, rectal stenosis and elephantiasis of the labia majora and minora.

4. Late symptoms

After several years or decades, long-term recurrent inguinal lymphangiitis can cause pubic elephantiasis, rectal stenosis, etc.

5. Systemic symptoms

During the period of lymphadenopathy and suppuration, there may be systemic symptoms such as chills, high fever, joint pain, fatigue, and hepatosplenomegaly. There are also skin erythema multiforme, erythema nodosum, conjunctivitis, sterile arthritis, pseudomeningitis, etc.

examine

1. Serum antibody testing

The main ones include microimmunofluorescence test, enzyme-linked immunosorbent assay, etc. Detection of high titer of anti-Chlamydia trachomatis is of great significance for the diagnosis of the disease.

2. Chlamydia culture, antigen detection method, nucleic acid detection method

Chlamydia culture is the most specific method for diagnosing the disease, but it is not very sensitive. Antigen detection methods such as enzyme immunoassay are relatively simple and rapid, but their sensitivity is not high. Nucleic acid detection is very sensitive and specific and can also be used for laboratory examination of the disease.