Abstract
We present four cases of proctitis in HIV-infected men having sex with men (MSM) living in the Czech Republic. The causative agent in all cases was the lymphogranuloma venereum (LGV) biovar of Chlamydia trachomatis.
The spread of proctitis caused by C. trachomatis serovars L1-3 among MSM has been observed in several European countries, the United States and Canada since 2003. To our knowledge, no LGV cases in eastern Europe have been published to date.
Between February 2010 and February 2011, four men who have sex with men (MSM) infected with human immunodeficiency virus (HIV), who were under regular observation for HIV infection at the Bulovka University Hospital AIDS Center in Prague, Czech Republic, developed symptoms of acute proctitis. The most prominent symptom in all four patients was intensive rectal pain lasting on average 10 days (range: 7-21 days).
Other symptoms included blood in the stool or pinkish mucous discharge, constipation and tenesmus. Case 1 also had one enlarged, painful inguinal lymph node.
Anoscopies were performed on Case 1 and Case 3 and revealed congested, irritated mucous membranes with a whitish coating. None of the patients had urethritis, fever, or other systemic symptoms (see Table).
To our knowledge, these cases are the first LGV infections detected in the region.