Venereal lymphogranuloma - Causes, symptoms and treatment. MF.
Venereal lymphogranuloma( venous lymphogranulomatosis) is an infectious disease belonging to the venereal group, affecting mainly the skin and lymph nodes. In old textbooks it is also called the "fourth venereal disease", since it was described after gonorrhea, syphilis, soft chancre and "Durant-Nicolas-Favre disease".By the name of the French doctors who opened it in 1913.The disease is widespread in East and West Africa, India, parts of South-East Asia, South America. In our country, Europe there are only imported cases.
Pathogen of venereal lymphogranuloma
Called by a well-known microbe: chlamydia trachomatis, but it's a slightly different chlamydia, not one that is responsible for urogenital chlamydia. It has varieties( serotypes).It is believed that the venereal lymphogranuloma is caused by L1, L2, L3.
The causative agent is spread through sexual contacts.
Symptoms of venereal lymphogranuloma
From the moment of infection until the appearance of the first symptoms, it takes 3 to 12 days. Frequent localization in men is the head of the penis, in women in the vagina or labia. With non-traditional sexual contacts in the tongue, rectum, fingers. On the site of the introduction of the pathogen appear vesicles, erosion( damage in this case skin) and sores. They do not bring any unpleasant sensations. This is the first stage of the disease.
Symptoms of the 1st stage of the venereal lymphogranuloma
Patients begin to seek help at the second stage, when the lymph nodes enlargement is attached, usually it is inguinal or nearby( for example, cervical, submaxillary if the oral cavity is affected), which are abruptly painful, the skin over them edematic, theycan be opened with the formation of fistula( orifices).
Symptoms of venereal lymphogranuloma 2 stage
Further infection spread throughout the lymphatic system. At the same time, the state of health deteriorates: headache, fever, nausea, vomiting. In this period of time, rashes on the skin, which are similar to a rash in allergic reactions, often appear.
When the process is localized in the rectum, we see symptoms of proctitis: anal itching, discharge from the anus, pain in the rectum. All these phenomena can spontaneously calm down and flare up again.
In malignant course, venereal lymphogranuloma can be the cause of miscarriages, early births during pregnancy, and in complications and inability to conceive a child.
Diagnosis of venereal lymphogranuloma
Differential diagnosis of lymphogranuloma: a symptom-like disease similar to genital herpes, syphilis, mild chancroid, lymphogranulomotosis, skin tuberculosis, proctitis, rectal cancer. The exact diagnosis can be made only by a specialist, using also the additional methods of research( laboratory).Therefore, you should get advice dermatovenereologist.
Laboratory diagnostics, to some extent, causes difficulty. Since it is possible to cross-react with other chlamydia, found in the body and innocent in this disease. Isolate the pathogen in chick embryos, which are injected with the test material: ulcer discharge, lymph. On the analysis of blood, you can identify antibodies, protective proteins for the introduction of the pathogen( serological reactions).
In general, the diagnosis is based on the clinical picture, additional research methods and examination of sexual partners. It is also necessary to exclude all diseases transmitted sexually. Often, consultation and other specialists are required for differentiation with other pathologies( oncologists, surgeons, gynecologists, urologists).
Treatment of venereal lymphogranuloma
During the course of treatment, antibiotics of the macrolide group( erythromycin, chemomycin), tetracyclines( unidox), antibacterial drugs( sulfalene), immunotherapy( cycloferon, neovir), vitamin therapy, local therapy( tetracycline ointment) are used. Inflamed lymph nodes often require surgical intervention: opening and draining them.
Since alcohol reduces immunity, gives side effects together with an antibiotic, reduces its effectiveness, from alcohol during treatment must be completely abandoned. During tetracyclines, you can not sunbathe( the skin is sensitive to the sun during this period) and use milk and dairy products, since they neutralize the antibiotic. If there is a selection of ulcers, it is recommended that the bed and bath linen be changed frequently.
After treatment the patient is under observation until all the symptoms of the disease disappear and the positive dynamics of the tests.
Treating an exotic disease with folk remedies is not effective and a pernicious mass of complications.
Complications of venereal lymphogranuloma
If you still run a venereal lymphogranuloma, the process goes into the third stage. It can affect all organs and tissues, with their destruction: the brain( meningitis - inflammation of the membranes of the brain), pneumonia, the heart( myocarditis). .. It is very possible formation of fistulas between the uterus and bladder, rectum, urethra and scrotum. As a result of inflammation and stagnation of lymph, elephantiasis is formed( a disfiguring appearance due to the increase in the skin and subcutaneous tissue).As a consequence of the destruction of cells, connective tissue is formed, there are scars that lead to stricture of the urethra, vagina( violation of the entrance), adhesions between organs.
Prevention of
Prevention of this infection is the same as for all STDs: the exclusion of casual sex, the use of condoms, the treatment of external and internal genital organs with solutions of chlorhexidine and miramistine.
Consultation of a doctor for venereal lymphogranuloma
Question: Is it possible to infect venereal lymphogranuloma by consuming exotic fruits?
Answer: No. Orally it is not transmitted.
Question: What contacts are subject to preventive treatment?
Answer: All persons who have been in sexual contact with a sick person for 30 days. The rest are under observation.
Question: Can other chlamydia degenerate into a causative agent of venereal lymphogranuloma?
Answer: no
Doctor dermatovenereologist Mansurov A.S.