General
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• Sexually transmitted disease caused by Chlamydia trachomatis serotypes L1, L2 and L3 (Mod Pathol 1995;8:924, MedlinePlus, eMedicine, Wikipedia)
• Endemic in tropical areas, rare in industrialized countries
• Outbreaks in Western Europe among male homosexuals (Rev Prat 2005;55:1747), in Bahamas associated with crack cocaine and HIV (Sex Transm Dis 2002;29:253)
• Three clinical stages (see references below)

Diagnosis
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• PCR
• Previously Frei test (delayed hypersensitivity skin test using “lygranum” chlamydial antigen)

Treatment
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• Doxycycline for 21 days

Micro description
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• Early - tiny necrotic foci with neutrophils
• Late - stellate abscesses surrounded by pale epithelioid cells
• Abscesses may merge, and sinus tracts may develop
• Macrophages may have organisms within vacuoles

Micro images
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Site unknown: various images

Contributed by Dr. Mark R. Wick

Virtual slides
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Lymphogranuloma venereum

Electron microscopy description
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• Elementary and reticulate bodies

Differential diagnosis
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• Atypical mycobacteria
• Cat-scratch disease: see J Clin Microbiol 2000;38:2062
• Tularemia

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