Authors:

H.J.C. de Vries,  B. de Barbeyrac,  N.H.N. de Vrieze,  J.D Viset,  J.A. White, M. Vall‐Mayans, M. Unemo

Source:

The European Academy of Dermatology and Venereology

Abstract

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.

Read the whole guideline HERE.