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Article << Previous     |     Next >>   Contents Vol 3(3)

Anorectal lymphogranuloma venereum in a Melbourne man

Anna N. Morton A D, Christopher K. Fairley A B, Angelo M. Zaia C, Marcus Y. Chen A B

A Melbourne Sexual Health Centre, 580 Swanston St, Carlton, VIC 3053, Australia.
B School of Population Health, University of Melbourne, Melbourne, VIC 3010, Australia.
C Microbiological Diagnostic Unit, Department of Microbiology and Immunology, University of Melbourne, Melbourne, VIC 3010, Australia.
D Corresponding author. Email: amorton@mshc.org.au
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We report the first case of anorectal lymphogranuloma venereum (LGV) in a man who has sex with men (MSM) in Australia in the setting of the recent emergence of LGV among MSM in Europe and the USA. A 33-year-old man presented with a 2 month history of mild external anal discomfort. He gave a history of unprotected receptive and insertive anal intercourse with one partner in Europe during the preceding 6 months. No symptoms suggested proctitis and examination revealed two small anal fissures. An anal swab was positive for Chlamydia trachomatis; investigation for other STIs including HIV were negative. On review 6 days later, he was investigated and treated presumptively for LGV. The LGV diagnosis was confirmed by identifying the L2 serovar of C. trachomatis using a genotype test on the original anal specimen. This case is in keeping with the more recent reports of LGV from Europe, and has demonstrated the need for a high index of suspicion for asymptomatic or minimally symptomatic anorectal LGV.

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