Lymphogranuloma venereum proctitis masquerading as inflammatory bowel disease in 12 homosexual men

Abstract

SUMMARY BackgroundLymphogranuloma venereum (LGV) is a recognized cause of proctitis. Symptoms, endoscopy and histology findings are similar in IBD and LGV proctitis.

Clues to uncommon and easily overlooked infectious diagnoses affecting the GI tract and distinction from their clinicopathologic mimics

“…51 Both pathologists and gastroenterologists must be aware of the significant overlap between STI proctitis and IBD in order to avoid misdiagnosis and mismanagement. This need is underscored by documented reports such as that of Soni et al, 54 in which 12 men with LGV proctitis were misdiagnosed and erroneously treated for IBD. All symptoms resolved after appropriate LGV-based treatment.…”

Infectious Proctitis: When to Suspect It Is Not Inflammatory Bowel Disease

“…Longstanding LGV can lead to granulomas, colorectal fistulae and fibrotic strictures, which can create histological, endoscopic and radiological views that can mimic Crohn's disease [22,23]. This was illustrated in a recent report that described 12 patients with an initial diagnosis of Crohn's disease, but this diagnosis was subsequently reversed to LGV in all patients [24].…”

Lymphogranuloma venereum proctitis: A differential diagnose to inflammatory bowel disease

“…Rectal cancer, shigellosis, amoebiasis and salmonellosis are among others. Inguinal lymphadenopathy is observed in patients with Non-Hodgkin's lymphoma (Tables I and II) [2,4,6,8,15,16,20,21].…”

“…Serovars A, B, Ba and C are associated with ocular trachoma, strains D-K with genital or conjunctival infections while only serovars L1-L3 cause LGV [11][12][13][14][15][16]. Most LGV cases in western countries are caused by serovar L2b, which is to be considered the primary etiological agent, but in rare occasions, cases with serovars L1 and L3 have been observed.…”