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Genital elephantiasis and sexually transmitted infections - revisited.
Int J STD AIDS. 2006 Mar; 17(3):157-65; quiz 166.IJ

Abstract

Genital elephantiasis is an important medical problem in the tropics. It usually affects young and productive age group, and is associated with physical disability and extreme mental anguish. The majority of cases are due to filariasis; however, a small but significant proportion of patients develop genital elephantiasis due to bacterial sexually transmitted infections (STIs), mainly lymphogranuloma venereum (LGV) and donovanosis. STI-related genital elephantiasis should be differentiated from elephantiasis due to other causes, including filariasis, tuberculosis, haematological malignancies, iatrogenic, or dermatological diseases. Laboratory investigations like microscopy of tissue smear and nucleic acid amplification test for donovanosis, and serology and polymerase chain reaction for LGV may help in the diagnosis, but in endemic areas, in the absence of laboratory facilities, diagnosis largely depends on clinical characteristics. The causative agent of LGV, Chlamydia trachomatis serovar L1-L3, is a lymphotropic organism which leads to the development of thrombolymphangitis and perilymphangitis, and lymphadenitis. Long-standing oedema, fibrosis and lymphogranulomatous infiltration result in the final picture of elephantiasis. Elephantiasis in donovanosis is mainly due to constriction of the lymphatics which are trapped in the chronic granulomatous inflammatory response generated by the causative agent, Calymmatobacterium (Klebsiella) granulomatis. The LGV-associated genital elephantiasis should be treated with a prolonged course of doxycycline given orally, while donovanosis should be treated with azithromycin or trimethoprim-sulphamethoxazole combination given for a minimum of three weeks. Genital elephantiasis is not completely reversible with medical therapy alone and often needs to be reduced surgically.

Authors+Show Affiliations

Department of Dermatology and Venereology, Chandigarh, India. someshgupta@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

16510000

Citation

Gupta, Somesh, et al. "Genital Elephantiasis and Sexually Transmitted Infections - Revisited." International Journal of STD & AIDS, vol. 17, no. 3, 2006, pp. 157-65; quiz 166.
Gupta S, Ajith C, Kanwar AJ, et al. Genital elephantiasis and sexually transmitted infections - revisited. Int J STD AIDS. 2006;17(3):157-65; quiz 166.
Gupta, S., Ajith, C., Kanwar, A. J., Sehgal, V. N., Kumar, B., & Mete, U. (2006). Genital elephantiasis and sexually transmitted infections - revisited. International Journal of STD & AIDS, 17(3), 157-65; quiz 166.
Gupta S, et al. Genital Elephantiasis and Sexually Transmitted Infections - Revisited. Int J STD AIDS. 2006;17(3):157-65; quiz 166. PubMed PMID: 16510000.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Genital elephantiasis and sexually transmitted infections - revisited. AU - Gupta,Somesh, AU - Ajith,C, AU - Kanwar,Amrinder J, AU - Sehgal,Virendra N, AU - Kumar,Bhushan, AU - Mete,Uttam, PY - 2006/3/3/pubmed PY - 2006/6/29/medline PY - 2006/3/3/entrez SP - 157-65; quiz 166 JF - International journal of STD & AIDS JO - Int J STD AIDS VL - 17 IS - 3 N2 - Genital elephantiasis is an important medical problem in the tropics. It usually affects young and productive age group, and is associated with physical disability and extreme mental anguish. The majority of cases are due to filariasis; however, a small but significant proportion of patients develop genital elephantiasis due to bacterial sexually transmitted infections (STIs), mainly lymphogranuloma venereum (LGV) and donovanosis. STI-related genital elephantiasis should be differentiated from elephantiasis due to other causes, including filariasis, tuberculosis, haematological malignancies, iatrogenic, or dermatological diseases. Laboratory investigations like microscopy of tissue smear and nucleic acid amplification test for donovanosis, and serology and polymerase chain reaction for LGV may help in the diagnosis, but in endemic areas, in the absence of laboratory facilities, diagnosis largely depends on clinical characteristics. The causative agent of LGV, Chlamydia trachomatis serovar L1-L3, is a lymphotropic organism which leads to the development of thrombolymphangitis and perilymphangitis, and lymphadenitis. Long-standing oedema, fibrosis and lymphogranulomatous infiltration result in the final picture of elephantiasis. Elephantiasis in donovanosis is mainly due to constriction of the lymphatics which are trapped in the chronic granulomatous inflammatory response generated by the causative agent, Calymmatobacterium (Klebsiella) granulomatis. The LGV-associated genital elephantiasis should be treated with a prolonged course of doxycycline given orally, while donovanosis should be treated with azithromycin or trimethoprim-sulphamethoxazole combination given for a minimum of three weeks. Genital elephantiasis is not completely reversible with medical therapy alone and often needs to be reduced surgically. SN - 0956-4624 UR - https://www.unboundmedicine.com/medline/citation/16510000/Genital_elephantiasis_and_sexually_transmitted_infections_-_revisited. L2 - https://journals.sagepub.com/doi/10.1258/095646206775809150?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -