Genital elephantiasis and sexually transmitted infections - revisited.
Identifieur interne : 007970 ( Main/Exploration ); précédent : 007969; suivant : 007971Genital elephantiasis and sexually transmitted infections - revisited.
Auteurs : Somesh Gupta [Inde] ; C. Ajith ; Amrinder J. Kanwar ; Virendra N. Sehgal ; Bhushan Kumar ; Uttam MeteSource :
- International journal of STD & AIDS [ 0956-4624 ] ; 2006.
Descripteurs français
- KwdFr :
- Femelle, Granulome inguinal (diagnostic), Humains, Lymphogranulomatose vénérienne (diagnostic), Lymphogranulomatose vénérienne (physiopathologie), Lymphogranulomatose vénérienne (traitement médicamenteux), Lymphogranulomatose vénérienne (épidémiologie), Maladies de l'appareil génital féminin (diagnostic), Maladies de l'appareil génital mâle (diagnostic), Maladies sexuellement transmissibles, Mâle, Éléphantiasis (microbiologie).
- MESH :
- diagnostic : Granulome inguinal, Lymphogranulomatose vénérienne, Maladies de l'appareil génital féminin, Maladies de l'appareil génital mâle.
- microbiologie : Éléphantiasis.
- physiopathologie : Lymphogranulomatose vénérienne.
- traitement médicamenteux : Lymphogranulomatose vénérienne.
- épidémiologie : Lymphogranulomatose vénérienne.
- Femelle, Humains, Maladies sexuellement transmissibles, Mâle.
English descriptors
- KwdEn :
- Elephantiasis (microbiology), Female, Genital Diseases, Female (diagnosis), Genital Diseases, Male (diagnosis), Granuloma Inguinale (diagnosis), Humans, Lymphogranuloma Venereum (diagnosis), Lymphogranuloma Venereum (drug therapy), Lymphogranuloma Venereum (epidemiology), Lymphogranuloma Venereum (physiopathology), Male, Sexually Transmitted Diseases.
- MESH :
- diagnosis : Genital Diseases, Female, Genital Diseases, Male, Granuloma Inguinale, Lymphogranuloma Venereum.
- drug therapy : Lymphogranuloma Venereum.
- epidemiology : Lymphogranuloma Venereum.
- microbiology : Elephantiasis.
- physiopathology : Lymphogranuloma Venereum.
- Female, Humans, Male, Sexually Transmitted Diseases.
Abstract
Genital elephantiasis is an important medical problem in the tropics. It usually affects young and productive age group, and is associated with physical disability and extreme mental anguish. The majority of cases are due to filariasis; however, a small but significant proportion of patients develop genital elephantiasis due to bacterial sexually transmitted infections (STIs), mainly lymphogranuloma venereum (LGV) and donovanosis. STI-related genital elephantiasis should be differentiated from elephantiasis due to other causes, including filariasis, tuberculosis, haematological malignancies, iatrogenic, or dermatological diseases. Laboratory investigations like microscopy of tissue smear and nucleic acid amplification test for donovanosis, and serology and polymerase chain reaction for LGV may help in the diagnosis, but in endemic areas, in the absence of laboratory facilities, diagnosis largely depends on clinical characteristics. The causative agent of LGV, Chlamydia trachomatis serovar L1-L3, is a lymphotropic organism which leads to the development of thrombolymphangitis and perilymphangitis, and lymphadenitis. Long-standing oedema, fibrosis and lymphogranulomatous infiltration result in the final picture of elephantiasis. Elephantiasis in donovanosis is mainly due to constriction of the lymphatics which are trapped in the chronic granulomatous inflammatory response generated by the causative agent, Calymmatobacterium (Klebsiella) granulomatis. The LGV-associated genital elephantiasis should be treated with a prolonged course of doxycycline given orally, while donovanosis should be treated with azithromycin or trimethoprim-sulphamethoxazole combination given for a minimum of three weeks. Genital elephantiasis is not completely reversible with medical therapy alone and often needs to be reduced surgically.
DOI: 10.1258/095646206775809150
PubMed: 16510000
Affiliations:
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Le document en format XML
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<front><div type="abstract" xml:lang="en">Genital elephantiasis is an important medical problem in the tropics. It usually affects young and productive age group, and is associated with physical disability and extreme mental anguish. The majority of cases are due to filariasis; however, a small but significant proportion of patients develop genital elephantiasis due to bacterial sexually transmitted infections (STIs), mainly lymphogranuloma venereum (LGV) and donovanosis. STI-related genital elephantiasis should be differentiated from elephantiasis due to other causes, including filariasis, tuberculosis, haematological malignancies, iatrogenic, or dermatological diseases. Laboratory investigations like microscopy of tissue smear and nucleic acid amplification test for donovanosis, and serology and polymerase chain reaction for LGV may help in the diagnosis, but in endemic areas, in the absence of laboratory facilities, diagnosis largely depends on clinical characteristics. The causative agent of LGV, Chlamydia trachomatis serovar L1-L3, is a lymphotropic organism which leads to the development of thrombolymphangitis and perilymphangitis, and lymphadenitis. Long-standing oedema, fibrosis and lymphogranulomatous infiltration result in the final picture of elephantiasis. Elephantiasis in donovanosis is mainly due to constriction of the lymphatics which are trapped in the chronic granulomatous inflammatory response generated by the causative agent, Calymmatobacterium (Klebsiella) granulomatis. The LGV-associated genital elephantiasis should be treated with a prolonged course of doxycycline given orally, while donovanosis should be treated with azithromycin or trimethoprim-sulphamethoxazole combination given for a minimum of three weeks. Genital elephantiasis is not completely reversible with medical therapy alone and often needs to be reduced surgically.</div>
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