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Treatment of Lymphogranuloma Venereum.
Clin Infect Dis 2007; 44(Supp 3):S147-S152.
McLean C, Stoner B, Workowski KA.
Abstract
BACKGROUND: Lymphogranuloma venereum (LGV) classically presents with 1 or
more genital ulcers or papules, as well as inguinal lymphadenopathy (buboes).
Recently reported cases of LGV proctitis in men who have sex with men, many
of whom are coinfected with human immunodeficiency virus (HIV), have highlighted
the importance of optimal clinical treatment of LGV. METHODS: A review was
conducted of the literature on LGV published between 1998 and 2004, as part
of the development of the 2006 sexually transmitted disease treatment guidelines
of the Centers for Disease Control and Prevention (CDC). RESULTS: Doxycycline
(100 mg orally twice daily for 21 days) remains the treatment of choice for
LGV. No controlled trials support the use of azithromycin or the use of alternative
treatment regimens for persons with HIV infection. CONCLUSIONS: On the basis
of the present literature review, the CDC's treatment recommendations for
LGV remain unchanged. LGV clinical care, surveillance, and research are severely
hindered by the lack of widely available, rapid, standardized tests for the
diagnosis of LGV; therefore, patients with symptoms suggestive of LGV, including
LGV proctitis, should be presumptively treated with antibacterial therapy
for 3 weeks.