San Francisco public health officials warned on Monday that four gay men in the city have contracted a rare and potentially debilitating STD, which was recently reported in the Netherlands, reports the San Francisco Chronicle. Lymphogranuloma venereum, or LGV, is a form of chlamydia rarely seen outside poor tropical nations. It can cause genital and colon scarring and can produce a swelling and rupturing of lymph glands near the groin. Rotterdam doctors reported 92 cases among gay men during a 17-month period ending in September. Isolated cases have also been reported in Belgium, France, Sweden, and the United States (Atlanta).
In November, San Francisco City Clinic doctors treated one man with LGV, and subsequent testing of more than 100 previously stored rectal chlamydia specimens from patients turned up three more LGV cases. None of the infected patients had visited the Netherlands, so there may be other people with undiagnosed LGV in the city, Sam Mitchell, a Department of Public Health epidemiologist, told the Chronicle. Some LGV-infected San Francisco patients also had HIV. While there is no sign HIV-positive patients are at higher risk for LGV-related complications, patients might be more likely to contract HIV because of the ulcerations caused by LGV, Mitchell said.
Because early LGV infections are difficult to distinguish, officials recommend treating all rectal chlamydia cases with the three-week course of antibiotics used to successfully treat LGV. A single dose is usually required for more common chlamydia strains. "The idea is to knock it out quickly. If it circulates widely, it could be quite challenging," Mitchell told the Chronicle. "We think doctors should err on the side of caution."