Lymphogranuloma venereum

1. LYMPHOGRANULOMA
VENEREUM

2. LABORATORY DIAGNOSIS:
• Specimen required are:
Serum
scraping from ulcer base
lymph node aspirate

3. DIAGNOSTIC MODALITIES:
1. Microscopy
2. Direct immunofluorescence
3. Culture
4. Serology
5. Nucleic acid amplification tests(NAAT)

4. MICROSCOPY:
• Chlamydia are gram negative but they are poorly stained
• Hence microscopy is not recommended
• When stained with lugols iodine MIYAGAWA CORPUSCLE are
seen

5. DIRECT IMMUNOFLUORESCENCE:
• Swabs are rolled on to a taflon coated slide
• fixed in methanol
• Fluorescent tagged monoclonal antibody
• DIF is sensitive but specificity is poor

6. CULTURE:
• Previously considered as gold standard method
• Highly specific but less sensitive
• Time consuming
• Technically demanding
• CHOICE OF CELL LINE:
• McCoy, HeLa 229, BHK-21

7. SEROLOGY:
• Complement fixation test (>1:64) using LPS antigen
• ELISA- using LPS antigen
• Microimmunofluorescence(>1:512) using MOMP antigen

8. OTHER TESTS:
• FREI TEST:
• Previously used
• Demonstrate type 4 hypersensitivity reaction
• ID skin test

9. NAAT:
• Considered as gold standard method
• Highly sensitive and specific
• Less time consuming
• Can detect even few copies of DNA
• GENES TARGETED: 16S OR 23S rRNA

10. TREATMENT (CDC)
• Recommended Regimen
Doxycycline 100 mg orally BD for 21 days

11. TREATMENT (NACO)