Drug of choice for lymphogranuloma venerum: March 2005

Ans. A: Tetracycline Lymphogranuloma venereum (LGV) is a sexually transmitted infection caused by unique serovars of Chlamydia trachomatis (L1, L2, L3) that are unlike those that typically cause urethritis, cervicitis, and proctitis (A-K). The hallmark of LGV is unilateral or bilateral tender lymphadenopathy that dramatically evolves 2 to 6 weeks after the primary lesion. The involved lymph nodes increase rapidly in size, and pain and erythema are common. If adjacent to one another, several involved lymph nodes may coalesce. The central areas of such lymph nodes can then undergo necrosis. Fluctuant and suppurative lymph nodes then develop, causing the classic 'bubo' of LGV. The bubo may then rupture and drain purulent material, which is associated with relief from symptoms. The 'groove sign' characteristic of LGV is seen if both the inguinal and the femoral nodes are involved. Tetracycline is the first choice drugs for LGV. Apa from LGV, tetracyclines are drug of choice for: STDs-Chlamydial non-specific urethritis/endocervicitis, granuloma inguinale Atypical pneumonia Cholera Brucellosis Plague Relapsing fever Rickettsial infections-typhus, rocky mountain spotted fever, Q fever etc.