Chlamydial genital tract infections

Lymphogranuloma venereum: Laboratory diagnosis.

Laboratory diagnosis

LGV is a lymphotropic infection and it induces a major cell mediated immune response. The Frei test, the classic delayed hypersensitivity skin test for LGV, is obsolete [Schachter & Osoba, 1983] and non-specific and should no longer be used. In LGV there is usually, but not always [Papagrigoriadis & Rennie, 1999] a high titre antibody response to the infecting organism which may be demonstrated by the micro-immunfluorescence test or, with less specificity and sensitivity, by ELISA or complement fixation test. However none of these tests are well defined or widely available [see: serology]. There have been few studies of modern molecular methods of diagnosing chlamydial infection in suspected LGV. However the studies of Htun et al., 1999 and others suggest that nowadays the best strategy in genital ulcer disease or lymphadenopathy is to test with the conventional commercial nucleic acid based kits for the presence of the LGV agent in the genital tract or in material aspirated from affected lymph nodes.

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Htun, Y., Morse, S. A., Dangor, Y., Fehler, G., Radebe, F., Trees, D. L., Beck-Sague, C. M. & Ballard, R. C. (1998). Comparison of clinically directed, disease specific, and syndromic protocols for the management of genital ulcer disease in Lesotho. Sexually Transmitted Infections 74, Suppl 1: S23 - 28.

Papagrigoriadis, S., Rennie, J. A. (1998). Lymphogranuloma venereum as a cause of rectal strictures. Postgraduate Medical Journal 74, 168 - 169.

Schachter, J. & Osoba, A. O. (1983). Lymphogranuloma venereum. British Medial Bulletin 39, 151 - 154.

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Topic revision: r6 - 2011-03-29 - SanderO
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