[Lymphogranuloma venereum. Two cases from Dresden]

Abstract

Lymphogranuloma venereum (LGV) caused by Chlamydia trachomatis serovar L1-3 was formerly a rare sexually transmitted disease in western countries. Recently, an outbreak of LGV and LGV proctitis among men who have sex with men (MSM) was reported from the Netherlands. We report two cases from Dresden, Germany, of white HIV1-infected MSM who presented in November 2004 with genital ulcers along with inguinal lymphadenitis (case 1) and ulcerative proctitis (case 2). The clinical picture and high titers of serum IgG and IgA antibodies pointed to infection with Chlamydia trachomatis. Appropriate specimens were positive for Chlamydia trachomatis with culture and PCR. Subsequent genotyping of the major outer membrane protein (MOMP) by restricted fragment length polymorphism confirmed serovar L2. Treatment with doxycycline for 3-4 weeks was effective. The incidence of LGV is increasing among MSM in Europe. Since most of the reported cases have been HIV1-infected and ulcerative STDs enhance HIV transmission, both health care providers and patients should be more aware of LGV.