Inguinal lymphogranulomatosis

The inguinal lymphogranulomatosis (synonym: the fourth venereal disease, a disease of Nikola - favr) is a chronic infectious disease, caused by a filterable virus. Transmitted through sexual intercourse. In Russia does not currently meet. The incubation period of 10 to 25 days. The primary lesion is localized usually in the genital area, has the appearance of the papules, bubble, erosion and after a few days alone heals, often without being noticed. After a few weeks or months mycosis inguinal, hereinafter - femoral, pelvic lymph nodes (ADaNet and perident), accompanied by fever, the enlargement of the spleen, leukocytosis. At the height of the disease in the groin area is formed Hurst, associated with skin, extensive painful infiltrate, the thickness of which is felt dense nodes are interspersed with areas of softening. In place of the collapsed and the found lymph nodes are visible fistulous holes and pustulezny moves with purulent discharge, healing after a few months or years scar. The result of this may gradually evolve in the respective areas disorder of pelvic - lymphostasis and related lymph elephantiasis. Foci seal tissues, ulceration and fistula arising in the area of the rectum and anus, lead to a narrowing of the intestine and cause intestinal obstruction (the so-called rectal syndrome). Women often affects the vagina, external genital organs, where develop progressive ulceration and cicatricial changes, leading to deformation of the clitoris, large and small lips (estimen). For diagnosis of the inguinal lymphogranulomatosis important positive reaction Frey (intradermal administration of a vaccineprepared from the pus of neskryvaemoy buboes patient). Treatment: sulfanilamida, antibiotics (biomitsin, chloramphenicol, penicillin and other) by a doctor; persistent cases of x - ray or radiation therapy.

Chlamydia crotch [lymphogranulomatosis inguinalis; synonym: microadenitis inguinalis suppurativa (L. A. Sobolev), a disease of Nikola-favr, fourth
sexually transmitted disease] is a disease, characterized by a kind of lymph nodes and mainly transmitted sexually. In the USSR, inguinal lymphogranulomatosis currently not registered.
Inguinal lymphogranulomatosis called filterable virus forming elementary cells and intracellular inclusions - bullock Miyagawa (Miyagawanella lymphogranuloma). Bullock, have a diameter of 1-4 MK and are usually groups. The virus thermolabile, at 60 dies within 30 minutes without losing antigenic properties.
Histologically in the affected lymph nodes observed diffuse inflammation. Everywhere detected small abscesses of irregular shape, surrounded by a belt of epithelioid cells. Sometimes giant cells Langhans, at least - cell-like cells Sternberg. Numerous plasma cells. For late defeats the inguinal lymphogranulomatosis (UB-genito-ANO-rectal) syndrome is characterized by chronic inflammation. In the Central part of granulomas can sometimes detect phenomena necrosis.
Reinfection with L. p. not observed. In the body of persons who have suffered L. p., an allergic restructuring which maintained for many years. This is evidenced by the positive intradermal reaction Freya with Pushkinoj, for which pus, collected in puncture bubo patient L. p., bred in 3 - 5 times a physiological solution and heated 3 days 1 hour at temperature of 60 degrees. In positive cases, the injection of postaccini develops papule inflammatory nature. You can use the vaccine, produced from the brain tissue of mice infected with a virus, this reaction is very important to clarify the diagnosis.
From the moment of infection before the first signs of the disease runs from 10 to 25 days, sometimes longer. The primary lesion looks papule, vesicle, or erosion, which often localized on the genitals. The most characteristic for the inguinal lymphogranulomatosis is the lymph nodes that occur a few weeks after the primary lesion (the second period of the disease). First observed in a patient pain, weakness, loss of appetite, fatigue, fever; temperatures rise to 38-39 C; spleen increases, leukocytosis - up to 10 000. Then increase the regional lymph nodes. Because the disease is usually transmitted sexually, usually increase inguinal, femoral, and then piliakalnio and pelvic lymph nodes. The skin over the affected nodes becomes bluish coloration. Soon enlarged lymph nodes appear pockets fluctuations, the skin over which thinner and mounted, pierces with allocation of viscous yellowish-green pus. Arising fistulous passages do not have a tendency to spontaneous healing. The remaining cicatricial changes, and changes in the affected lymph nodes are often accompanied by a persistent violation of the lymph circulation and lymphostasis in the relevant areas; consequently, during the gradual progression of the disease can develop elephantiasis with the advent of ulcerations and fistulas in Uro-genito-ANO-rectal areas - the third period of the disease (with E. K.; Alexandrov). Scars can cause rectal stricture until its obstruction.
The forecast should be followed carefully. The disease is severe, difficult to treat and can lead to serious complications.
Treatment. Sulfanilamida, antibiotics (biomitsin, chloramphenicol, streptomycin, penicillin), use drugs antimony - infusion of 1 % solution Stibium kalio-tartaricum. Surgical treatment - excision of the affected lymph nodes recommended by some authors, facing severe violations of lymphatic drainage and development elephantiasis of the genitals. Absolute indication for surgery is stricture of the anus and rectum. In these cases, the scar excision with a plastic replacement formed defects mucous membrane.
Prevention. In case of illness it is necessary to carry out the whole complex of the follow up activities.