2019 European guideline on the management of lymphogranuloma venereum

• Published in: Journal of the European Academy of Dermatology and Venereology 2019-10, Vol.33 (10), p.1821-1828
• Main Authors: de Vries, H.J.C., de Barbeyrac, B., de Vrieze, N.H.N., Viset, J.D, White, J.A., Vall‐Mayans, M., Unemo, M.
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents - therapeutic use; Contact Tracing; Disease Notification; Europe; Humans; Life Sciences; Lymphogranuloma Venereum - diagnosis; Lymphogranuloma Venereum - drug therapy; Lymphogranuloma Venereum - etiology; Lymphogranuloma Venereum - therapy; Patient Education as Topic
• ISSN: 0926-9959; 1468-3083; 1468-3083
• DOI: 10.1111/jdv.15729

New or important issues in this updated version of the 2013 European guideline on the management of lymphogranuloma venereum (LGV): Epidemiology Lymphogranuloma venereum continues to be endemic among European men who have sex with men (MSM) since 2003. Lymphogranuloma venereum infections in heterosexuals are extremely rare in Europe, and there is no evidence of transmission of LGV in the European heterosexual population. Aetiology and transmission Chlamydia trachomatis serovars/genovars L2b and L2 are the causative strains in the majority of cases in Europe. Clinical features Among MSM, about 25% of the anorectal LGV infections are asymptomatic. Genital infections among MSM are rare; the ratio of genital vs. anorectal LGV infections is 1 in 15. Diagnosis To diagnose LGV, a sample tested C. trachomatis positive with a commercial nucleic acid amplification test (NAAT) platform should be confirmed with an LGV discriminatory NAAT. Treatment Doxycycline 100 mg twice a day orally for 21 days is the recommended treatment for LGV. This same treatment is recommended also in asymptomatic patients and contacts of LGV patients. If another regimen is used, a test of cure (TOC) must be performed.