STI Outpatient Clinic, Infectious Diseases Department, Public Health Service Amsterdam, Amsterdam, The Netherlands.
Department of Dermatology, Amsterdam Institute for Infection and Immunity (AI&II), Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
J Eur Acad Dermatol Venereol. 2019 Oct;33(10):1821-1828. doi: 10.1111/jdv.15729. Epub 2019 Jun 26.
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.
Chlamydia trachomatis serovars/genovars L2b and L2 are the causative strains in the majority of cases in Europe.
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.
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.
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.
在 2013 年欧洲淋巴肉芽肿（LGV）管理指南的更新版本中出现的新问题或重要问题：
流行病学：自 2003 年以来，LGV 一直是欧洲男男性行为者（MSM）中的地方病。在欧洲，异性恋者中的 LGV 感染极为罕见，也没有证据表明 LGV 在欧洲异性恋人群中传播。
病因和传播：衣原体血清型/基因型 L2b 和 L2 是欧洲大多数病例的致病菌株。
临床特征：在 MSM 中，约 25%的肛直肠 LGV 感染是无症状的。MSM 的生殖器感染很少见；生殖器与肛直肠 LGV 感染的比例为 1:15。
诊断：为诊断 LGV，用商业核酸扩增试验（NAAT）平台检测出的 C. trachomatis 阳性样本应使用 LGV 鉴别性 NAAT 进行确认。
治疗：推荐使用强力霉素 100mg，每天两次口服，共 21 天，作为 LGV 的治疗方法。对于无症状患者和 LGV 患者的接触者，也推荐同样的治疗方法。如果使用其他方案，则必须进行治愈测试（TOC）。
