Flexor G, Clarissou J, Gaillet M, de Barbeyrac B, Perronne C, de Truchis P
Département de médecine aiguë, service des maladies infectieuses et tropicales, hôpital Raymond-Poincaré, AP-HP, université Versailles-Saint-Quentin, 104, boulevard R.-Poincaré, 92380 Garches, France.
Ann Dermatol Venereol. 2010 Feb;137(2):117-20. doi: 10.1016/j.annder.2009.11.012. Epub 2009 Dec 30.
Lymphogranuloma venereum (LGV) is an uncommon sexually transmitted disease caused by the L serovars of Chlamydiae trachomatis. Since 2003-2004, a continued outbreak of LGV proctitis (C. trachomatis serovar L2b) has been reported in North America and Europe, including France, among homosexual males, especially with HIV co-infection.
A 41-year-old man presented penile ulceration of three weeks' standing, associated with a large swollen granulomatous lesion and an inguinal lymph node but without proctitis. All lesions resolved after a three-week course of doxycycline 200mg daily. These lesions were related to a genital bubo due to LGV as confirmed by positive specific PCR for C. trachomatis (serovar L2) performed on the genital ulceration.
Clinical descriptions of male genital LGV are infrequent, even during the LGV proctitis epidemic seen in Western countries in recent years. A diagnosis of LGV must be considered in the presence of sexually transmitted genital lesions, even atypical, especially among HIV-infected patients.
性病性淋巴肉芽肿（LGV）是一种由沙眼衣原体L血清型引起的罕见性传播疾病。自2003年至2004年以来，北美和欧洲，包括法国，均报告了LGV直肠炎（沙眼衣原体血清型L2b）在同性恋男性中持续爆发，尤其是合并感染HIV者。
一名41岁男性出现持续三周的阴茎溃疡，伴有一个肿大的肉芽肿性大病灶和一个腹股沟淋巴结，但无直肠炎。每日服用200mg强力霉素，疗程三周后，所有病灶均消退。对生殖器溃疡进行的沙眼衣原体（血清型L2）特异性PCR检测呈阳性，证实这些病灶与LGV引起的生殖器腹股沟淋巴结炎有关。
即使在近年来西方国家出现的LGV直肠炎流行期间，男性生殖器LGV的临床描述也很少见。对于存在性传播的生殖器病变，即使是非典型病变，尤其是在HIV感染患者中，必须考虑LGV的诊断。
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