Introduction: Lymphogranuloma venereum (LG) is a sexually transmitted infection (STI) caused by Chlamydia trachomatis L serovar.
Methods: These five consecutive cases aim to highlight the risk of LG misdiagnosis, in case of initial presentation with isolated inguinal adenitis.
Results: Five men (mean age: 30±7 years) were seen in an internal medicine department, for inguinal adenopathy. One patient had clinical signs of urethritis. None presented an associated rectitis. Three patients had a history of STI, and two had a discovery of related HIV disease. Urinary polymerase chain reaction (PCR) was positive for the symptomatic patient and negative for the others. Lymph node PCR was positive in all patients within a L2b serotype (searched in 4 out of 5 cases).
Conclusion: LG should be evoked in any patient with inguinal adenomegaly, particularly in case of STI history or risk factors. Negativity of urinary PCR should lead to further investigations, essentially a lymph node cytopuncture to evidence C. trachomatis.
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Article Synopsis
- Persistent inguinal lymphadenopathy can be caused by various conditions, including the sexually transmitted infection lymphogranuloma venereum (LGV), which may be overlooked due to diagnostic challenges.
- Two male patients with a high risk for STIs presented with inguinal lymphadenopathy; initial tests were negative, leading to prolonged diagnostic delays before confirming LGV.
- Both patients improved significantly after treatment with doxycycline, highlighting the importance of considering LGV in similar cases of persistent lymphadenopathy.
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