Sexually Transmitted Diseases (STDs in Men) (cont.)

Lymphogranuloma venereum is an uncommon genital or anorectal (affecting the anus and/or rectum) disease that is caused by a specific type of bacteria, Chlamydia trachomatis. With this infection, men typically consult a doctor because of tender glands (lymph nodes) in the groin. These patients sometimes report having recently had a genital ulcer that subsequently resolved. Other patients, particularly women and homosexual men, can have rectal or anal inflammation, scarring, and narrowing (stricture), which cause frequent, scant bowel movements (diarrhea) and a sense of incomplete evacuation of the bowels. Other symptoms of lymphogranuloma venereum include perianal pain (around the anal area) and occasionally drainage from the perianal area or the glands in the groin. If an ulcer appears, it is often gone by the time infected people seek care. Note that another strain (type) of Chlamydia trachomatis, which can be distinguished in specialized laboratories, causes inflammation of the urethra.

First, or primary, infection is characterized by an ulcer or irritation in the genital area and occurs 3 to 12 days following infection; these early lesions heal on their own within a few days. Two to six weeks later, the secondary stage of infection is characterized by spread of the infection to lymph nodes, causing the tender and swollen lymph nodes in the groin. The scarring that sometimes occurs following lymphogranuloma venereum arises if the infection is not treated adequately in its early stages.

The diagnosis of lymphogranuloma venereum is suspected in a person with typical symptoms and in whom other diagnoses, such as chancroid, herpes, and syphilis have been excluded. The diagnosis in such a patient is usually made by a blood test that detects specific antibodies to Chlamydia, which are produced as part of the body's immunologic (defensive) response to that organism.

Once lymphogranuloma venereum is diagnosed, it is usually treated with doxycycline. If this is not an option, for example, because of intolerance to the drug, erythromycin can be given as an alternative.

A person who has been sexually exposed to a person with lymphogranuloma venereum should be examined for signs or symptoms of lymphogranuloma venereum, as well as for chlamydial infection of the urethra, since the two strains of Chlamydia trachomatis can coexist in an infected person. If the exposure occurred within 30 days of the onset of their partner's symptoms of lymphogranuloma venereum, the exposed person should be treated.

Source: MedicineNet.com
http://www.medicinenet.com/sexually_transmitted_diseases_stds_in_men/article.htm