Lymphogranuloma venereum proctitis mimicking inflammatory bowel diseases in 11 patients: a 4-year single-center experience

• Published in: Crohn's & colitis 360 2019-05, Vol.1 (1)
• Main Authors: Di Altobrando, Ambra, Tartari, Federico, Filippini, Andrea, D'Antuono, Antonietta, Patrizi, Annalisa, Filippi, Federica, Sechi, Andrea, Cuicchi, Dajana, Salfi, Nunzio Cosimo Mario, Gaspari, Valeria
• Format: Article
• Language: English
• ISSN: 2631-827X; 2631-827X
• DOI: 10.1093/crocol/otz004

Lymphogranuloma venereum (LGV) is a sexually transmitted disease caused by Chlamydia trachomatis (CT) serovars L1–L3. Our study wants to underline the similarities between rectal LGV and idiopathic inflammatory bowel diseases (IBD), which can share clinical, endoscopic and histopathological findings.There are several medical conditions that can cause symptoms and test results that look like Crohn’s disease or ulcerative colitis [each classified as a form of inflammatory bowel disease (IBD)]. Thus, when people are initially being investigated for IBD, or have established IBD that is not responding to standard treatment, it is important for physicians to consider alternative diagnoses. In this article, the authors describe the features of 11 patients who were initially suspected to have IBD, but later diagnosed with a sexually transmitted infection of the rectum. Lymphogranuloma venereum (LGV) is a bacterial infection (Chlamydia trachomatis) that can infect the anus after anal-receptive sex. Most of the patients were being treated for IBD, but had not responded to their medications. Their symptoms, and even the appearance of their rectum on colonoscopy, were similar to what can be seen with IBD, leading to misdiagnosis. Once the correct diagnosis was recognized, thankfully all the patients responded to a 10-day course of antibiotics. The lesson from this study is that alternative diagnoses should always be considered in situations where treatment of IBD is not successful. Many of these other conditions are infections, that may just require antibiotics.