Spenatto Nathalie, Boulinguez Serge, de Barbeyrac Bertille, Viraben Roland
CIDDIST Hôpital La Grave, Place Lange, 31059 Toulouse Cedex 9, France.
Sex Transm Infect. 2007 Jul;83(4):337-8. doi: 10.1136/sti.2007.025395.
Since 2003, an ongoing lymphogranuloma venereum (LGV) proctitis outbreak has been reported in industrialised countries with a new variant designated L2b. Only men who have sex with men (MSM) are affected and most are HIV co-infected; delayed or incorrect diagnoses are frequent. We report a rare clinical case of LGV primary stage called "bubonulus" with penile adenopathy and secondary local acute lymphoedema in an MSM seropositive man. This is the first case described of this clinical presentation with a L2b genovar strain, occurring immediately after use of a sex toy. It suggests that this presentation is favoured by host immunity and behavioural factors. These factors may also play a part in the new outbreak of LGV.
自2003年以来，工业化国家报告了一起持续性的性病性淋巴肉芽肿（LGV）直肠炎疫情，涉及一种名为L2b的新变种。仅男男性行为者（MSM）受到影响，且大多数同时感染了艾滋病毒；诊断延误或错误的情况屡见不鲜。我们报告了一例罕见的LGV一期临床病例，称为“小腹股沟淋巴结炎”，发生在一名血清阳性的MSM男性身上，表现为阴茎淋巴结病和继发性局部急性淋巴水肿。这是首例描述这种临床表现且感染L2b基因变种毒株的病例，该病例在使用性玩具后立即出现。这表明这种表现受到宿主免疫和行为因素的影响。这些因素可能也在LGV的新疫情中发挥了作用。
