Lymphogranuloma Venereum in North America: Case Reports and an Update for Gastroenterologists

Background & Aims: In 2003, a sharp increase in cases of lymphogranuloma venereum (LGV) caused by Chlamydia trachomatis in men who have sex with men was reported in Europe and, recently, cases of LGV have been reported in North America. Methods: We reviewed 3 cases of LGV proctitis recently diagnosed in Canada. Results: All 3 cases occurred in men who had sex with men; 2 of the patients had human immunodeficiency virus infection and 1 subsequently seroconverted. A delay in diagnosis occurred in all 3 patients: 2 patients were misdiagnosed initially with inflammatory bowel disease and 1 patient was treated as a case of non-LGV C trachomatis. Conclusions: Given the recent outbreak, gastroenterologists in Europe and North America need to be familiar with the diagnosis and treatment of LGV because it mimics inflammatory bowel disease endoscopically and histologically.