Lymphopathia Venereum Research Articles

The establishment of lymphogranuloma inguinale (lymphopathia venereum) as a sexually transmitted disease.

The establishment of lymphogranuloma inguinale (lymphopathia venereum) as a sexually transmitted disease.

An operation for restoration of urinary continence following total loss of the urethra.

Twenty-three patients with urethral loss have been treated by the simple creation ofa "spout" from the bladder wall. The procedure is suggested for the surgical treatment of lymphopathia venereum and for consideration in certain other conditions when urinary diversion is unacceptable.

Sexual assault on women and girls in the District of Columbia.

This article presents a comprehensive report of forcible rape in the District of Columbia from September 15 1965 through June 30 1968. 1/2 of the 3000 complainants of alleged sexual assault were brought to medical attention almost all female. About 85% were nonwhite much higher than their representation in the population; ages ranged from 1-88 with the highest number at age 14; incidents varied from forcible and attempted rape through statutory rape to child molestation. Preexisting conditions at examination included pregnancy gonorrhea and syphilis. 4 females who had probably been raped died as a result of physical abuse prior to examination. Of the 18 patients hospitalized with severe injuries 6 were children with vaginal or perineal laceration; 50 patients required emergency room surgery or other treatment. Of 1000 referrals made by nurses to clinics and private physicians for reexamination 63% were completed. Of the 9 who became pregnant 7 were aborted; there were 3 new cases of syphilis 1 lymphopathia venereum and 58 of gonorrhea; 18 with a history of emotional disturbance were returned to treatment; follow-up revealed 53 women and girls with new emotional disturbances 42 of whom were brought to treatment; 7 patients were still under psychiatric supervision 18-24 months after the assault. It is suggested that initial medical examination should be done by a gynecology or pediatrics resident or staff member away from the emergency area and with attention to the emotional component. Follow-up examination should reevaluate the patient as a whole person.(AUTHORS MODIFIED)

SQUAMOUS METAPLASIA AND PAPILLOMATOSIS OF RECTUM.

Squamous metaplasia of the rectum may be the result of chronic inflammatory reaction in and about the rectum. Some of the pathological states which lead to squamous metaplasia of the rectal mucosa are of granulomatous origin due to venereal disease. Lymphopathia venereum is one of the conditions which can cause chronic granulomata. The incidence of rectal complications in lymphopathia venereum has always been regarded as extremely high, particularly in females. Since the disease has been most common in the Negro race, the reported rectal complications have ordinarily been found in Negro people as well. Presumably in the absence of pederasty, practiced mainly by the male, the disease spreads to the rectum by means of direct spread through the rectovaginal septum and drainage into the perirectal lymphatics with submucosal involvement and subsequently ulceration of the rectal mucosa and ultimate stricture formation. With this chronic inflammatory process, the mucosa may exhibit changes

Respiratory infections and antimicrobial therapy.

This article makes no attempt to summarize all recent literature dealing with respiratory infections and antimicrobials. The field is too large. New developments and highlights emphasized by many authorities have been collected, and such nuggets of information as exist are pointed out. Only material of special interest to the otolaryngologist is included. Viral Infections No viral infections are known that respond to antimicrobial drugs. Until recently, the agents causing psittacosis, trachoma, and lymphopathia venereum were called viruses. Now they have been reclassified. This new grouping has removed from the list of viruses the only agents that were susceptible to antimicrobials. The treatment of viral infections remains symptomatic. Steroid therapy has been recommended in certain viral diseases, such as mumps orchitis, herpes zoster, and infec

Surgical treatment of genital elephantiasis.

TWO MAJOR types of scrotal elephantiasis, arabum (tropicum) and nostros (nostra) are recognized. 1 Elephantiasis arabum develops secondary to filarial blockage of lymphatics; the nostrum type is sporadic and due to nonfilarial obstruction of lymph drainage from the inguinofemoral areas. Of the latter group, lymphopathia venereum is probably the most frequent cause in this country. Granuloma inguinale, which may not actually be a true venereal disease, 2 is less commonly an etiological agent. 3 Medical treatment is ineffective for long-standing elephantiasis of the genitalia from whatever cause. In both lymphopathia venereum and granuloma inguinale, the maximum value of antibiotic therapy is attained if treatment can be administered early. There has been little published in America on the surgical treatment of scrotal elephantiasis. Hinman 1 depicted a radical surgical removal of the scrotum by Kretchmar and recommended this procedure, to be followed by plastic formation of new penile and scrotal

A Case of Multiple Pulmonary Infarctions Occurring in an Ambulant Male, and Associated with Rectal Lesions

SUMMARY An unusual case of multiple pulmonary infarctions occurring in a presumably well, ambulant and active young male has been presented. Clinically it was striking that the embolic disease occurred in association with an unusual inflammatory process involving the hemorrhoidal veins which may have been due to the virus of lymphopathia venereum. It is recognized that this, association may be coincidental, but it is suggested that the hemorrhoidal veins may have been the source of these emboli since no other was demonstrated. The hypothesis presented above merits consideration, and it is hoped that in some small measure this report will stimulate clinical, pathological and experimental investigation of the rectal circulation in relation to pulmonary embolism.

The differential sheep cell agglutination test in arthritis.

While the serologic properties of blood of patients with rheumatoid arthritis have been studied extensively, no test of diagnostic value has, as yet, been devised. 7 Such a laboratory test would have considerable significance were it to confirm or eliminate an early rheumatoid state. In 1939 Waaler demonstrated in the serum of some persons a factor which agglutinated sheep red blood cells. A small amount of such serum, when added to specific agglutinating serum against sheep red cells, increased the titer of the specific serum remarkably. If a small amount of anti-sheep cell serum is added to one of these human serums, agglutination of sheep red blood cells will occur in high dilutions, whereas no agglutination appears without the addition of the specific agglutinating serum. This factor was found, in small amounts, in serums of patients with various diseases. I t was found in larger quantities in 22 of 43 patients (51 per cent) with rheumatoid arthritis. It was further demonstrated that this hitherto unknown factor was present in the globulin fraction of the serum, was relatively thermostable (withstanding 60 C. for one-half hour), and was not related to the heterophile antibodies or to the patient's blood group. These interesting observations, to our knowledge, did not provoke any further clinical or bacteriologic investigation. In 1948, however, Rose and his associates described a similar phenomenon in the serum of patients with rheumatoid arthritis. When inactivated human serums were set up in serial dilutions and tested against normal sheep erythrocytes and sensitized sheep erythrocytes, they disclosed that a sixteen-f old or greater increase in the agglutination of the sensitized cells occurred almost exclusively in patients with rheumatoid arthritis; in other forms of arthritis the reactions were much milder. These observers considered that the height of the differential titer reflected the clinical activity of the disease. Moreover, utilizing electrophoretic technics, this specific factor was demonstrated in the beta and gamma globulin fractions of the serum, and appeared to be unrelated to the antibody responsible for the Group A hemolytic streptococcus agglutination test. In a series of 51 patients exhibiting some form of rheuma toid arthritis, a positive serologic test was found in 38 patients (74.5 per cent). In 15 patients with rheumatic fever and in 15 other patients with arthritic manifestations, which included undifferentiated arthritis of mild character, degenerative joint disease, dermatomyositis, lupus erythematosus disseminatus, gout, gonorrheal arthritis, lymphopathia venereum and Sudeck's atrophy, the test was negative. An additional 29 patients, with a variety of diseases, free of arthritic manifestations or involvement, were also examined and in only 2 instances (7 per cent) was a positive reaction observed.

Chemotherapy of Virus Infections

Abstract Chemotherapy has become increasingly effective in attenuating the striking power of protozoal and bacterial diseases, but, except in isolated instances, this approach to the control of virus diseases has been unsuccessful. The exceptions, lymphopathia venereum, trachoma, inclusion blenorrhea, mouse pneumonitis and some members of the ornithosis group, are susceptible in varying degree to sulfonamides and penicillin (1). In a sense, this susceptibility to chemotherapeutic attack separates these diseases from the greater number of virus infections and suggests their more immediate descent from bacteria responsive to usual chemotherapeutic measures. It should be noted even here, that while the animals may be saved, active virus can sometimes be recovered from them. Although infections by viruses other than the noted exceptions may be influenced, and even controlled, by natural immune bodies, and by “interference” from other viruses, ordinary medicinal therapy has failed completely.

The Estrogen Treatment of Stricture of the Rectum Due to Lymphogranuloma Venereum1

CLINICAL observations noted accidentally may lead to new and important therapeutic conceptions. The treatment of stricture of the rectum due to lymphogranuloma venereum has, until the present time, been highly unsuccessful. The observation that a stricture of this type improves tremendously during pregnancy and renders the patient free from symptom after delivery stimulated the search for the explanation of this phenomenon. This report of four cases will serve to indicate the beneficial and almost specific effect of estrogens in alleviating rectal strictures of this type. Lymphogranuloma inguinale or lymphopathia venereum (9) is a wide spread communicable disease usually acquired venereally. It affects all races but is especially common in the colored race. It occurs in both males and females and gains entrance through the skin and mucous membranes. The disease is believed to be due to a filterable agent (2) and is diagnosed by a positive Frei test (1) and a positive complement fixation test (8).

The Use of a Commercially Available Complement-Fixing Antigen for the Diagnosis of Elementary Body Types of Viral Infection

Summary Complement-fixation tests with an egg-yolk-grown lymphopathia venereum antigen (“Lygranum CF”-Squibb) were performed on sera from patients with atypical pneumonia and from individuals with known exposure to venereal infection. The results were compared with those obtained with sera from patients with upper respiratory infections and influenza and from normal individuals. All tests included egg-yolk control antigens and Kolmer complement-fixation tests for syphilis. A modified micro Kolmer technic was used in testing with the “Lygranum CF” antigen which was comparable in sensitivity to the method recommended by the Squibb workers. There were 98 “controls,” 102 atypical pneumonia patients and 126 venereally exposed individuals who had satisfactory tests. Complete fixation with a serum dilution of at least 1 to 5 was found, respectively, in 28.6, 28.4 and 39 per cent of each of these groups. There was no correlation between the Kolmer serological test for syphilis and the “Lygranum” complement-fixation test. However, in the venereally exposed group there was a considerable number of patients whose serum reacted with the egg control antigen. Most of these showed positive Kolmer reactions. This phenomenon impairs the diagnostic value of the test among patients with venereal diseases. Twice as many atypical pneumonia as control sera reacted with the normal egg antigen. This observation is discussed. Quantitative titrations on a number of the positive sera from each group failed to reveal any clear-cut differentiation. However, quantitative study of more than one specimen of sera from each of 11 patients with respiratory infections revealed that 7 had a change in titer with progression of their disease. In 2, there was a rise in titer and in 5, a fall. In 4 of these 5, the first specimen to be examined was drawn after the second week of illness. Cutaneous and complement-fixation tests with “Lygranum” were performed on 77 venereally exposed patients. The serological test appeared more sensitive, though there were a few instances in which the cutaneous test was positive when complement fixation was negative.

IMMUNOLOGIC RELATIONSHIP OF DONOVANIA GRANULOMATIS TO GRANULOMA INGUINALE

1. A washed bacterial suspension of Donovan microorganisms cultivated in the yolk of chick embryos was used as an antigen in intracutaneous tests in 6 cases of granuloma inguinale in the active stage of the disease. These injections were responded to by an extensive erythematous and edematous reaction that reached its height in 24 hours and disappeared within 48 hours later. Four control cases without granuloma inguinale did not react to the injection to any greater extent than would be expected from the slight trauma incident to them. The skin of the reacting patients responded in a similar manner but to a lesser extent to a filtrate of infected yolk. Simultaneous control injections of filtered normal yolk demonstrated that sensitivity to normal yolk was not responsible for the reactions. 2. A mucoid material present in infected yolk, soluble in N/100 NaOH, and precipitable by N/100 HCl was recovered and purified by repeated acid precipitation, extraction with ether, washing in distilled water, and dissolution in N/100 NaOH. We regard this material to be of capsular origin. 3. The presumptive capsular material injected intradermally elicited a somewhat different and milder reaction in patients with active granuloma inguinale, but we regard it as specific. 4. The "capsularrdquo; material in suitable dilution elicited distinct precipitation reactions when mixed with the serum from 18 of 19 cases of active granuloma inguinale. Serum from 1 active case showed no precipitation. Sixty-four serums, including 6 from lymphopathia venereum patients and 18 from Wassermann- or Kahn-positive patients, and 1 from an early chancroid failed to precipitate. Two serums from a total of 66 used as controls showed a precipitate in the presence of the capsular material. These patients gave no history or evidence of granuloma inguinale. 5. The "capsular" material fixed complement in the presence of serum from patients with granuloma inguinale. Serum from 12 of 15 cases of granuloma inguinale demonstrated complement fixation. Three failed to fix complement. Of 19 control serums 18 failed to fix complement in the presence of the capsular material and 1 fixed only a very slight amount of complement. None of these serums nor the capsular material itself was anticomplementary. 6. The high proportion of precipitation and complement fixation reactions obtained from patients with active granuloma inguinale is indicative of a specific immunological relationship of the Donovan microorganism cultivated in embryonic yolk to the disease, granuloma inguinale. 7. We suggest that one or all of these methods might be so standardized as to be of distinct diagnostic value.

Pharmacology of Sodium Sulfanilylsulfanilate.

Sodium sulfanilylsulfanilate, a derivative of sulfanilamide, was first used therapeutically by Dochez and Slanetz1 against a fatal infection in ferrets supposed to be due to and resembling dog distemper. Maclntyre and Montgomerie2 in England employed this drug unsuccessfully in infections due to the distemper virus described by Carre-Laidlaw-Durkin. Oakley3 used it without benefit in experimental influenza. Coggeshall4 tested sodium sulfanilylsulfanilate in avian malaria. Hebb, Sullivan, and Felton5 recommended sodium sulfanilylsulfanilate and sodium sulfanilate for the treatment of lymphopathia venereum. This report deals with the pharmacology and toxicity of sodum sulfanilylsulfanilate.Sodium sulfanilylsuilate was determined by the Marshall6 method using alpha dimethylnaphthylamine in alcoholic solution as the coupling component. Determinations were made on whole blood, urine, and fecal discharges. The fate of single and repeated doses were studied in some normal subjects and in patients, following oral...

Stricture-forming lesions of the female genitals and rectum: A Year's study of cases in the district of columbia

1.1. Attempts have been made in the District of Columbia, at Gallinger Municapal Hospital, to develop facilities for the diagnosis and treatment of lesions of the female genitals.2.2. The use of sodium salt of sulfanilic acid in the treatment of lymphopathia venereum has been discussed.3.3. Corrective surgical procedures can be utilized in lymphopathia venereum of the vulva, the healing phase of granuloma inguinale and in the papillomatous growth of condyloma acuminatum.4.4. We have not necessarily explored new fields but have applied established diagnostic procedures. Only in this way can a higher percentage of correct diagnoses be made and proper therapy instituted.

Sulphanilamide in the treatment of ulcerative granuloma

1. 1. Six cases of ulcerative granuloma treated with varying combinations of antimony salts with sulphanilamide derivatives are described. 2. 2. Disadvantages and limitations of fuadin and sulphanilamide, used alone, are indicated. 3. 3. Favourable results obtained by combining fuadin injections with M. & B. 693 orally are recorded. 4. 4. A case of mixed infection (ulcerative granuloma and lymphopathia venereum) amenable to fuadin combined with M. & B. 693 is included in the series.

The anorectal aspect of venereal lymphogranuloma

Venereal lymphogranuloma, often termed lymphogranuloma inguinale, lymphopathia venereum, etc., is a venereal disease probably caused by a filterable virus. The universal adoption of the term venereal lymphogranuloma would avoid confusion, designate its venereal origin, it would give some conception of the nature of the condition, and embrace the multiple localizations and aspects of the disease. A history of an initial lesion is difficult to elicit because of the evanescent nature of the primary sore. It occurs on the penis in males and usually within the vagina in females. The manifestations of the disease in the two sexes differ because of the different anatomic locations of the initial lesions. In the male, the superficial inguinal lymph nodes become involved; in the female, however, the deep pelvic nodes as well as the nodes surrounding the rectum become involved. Secondary perirectal involvement may occur in males due to the passage of the virus along collateral lymphatic vessels. In our cases, rectal involvement occurred about four times as frequently in females than in males. The most serious sequela of the disease is rectal stricture which is the result of peri-rectal involvement producing obliterating, inflammatory narrowing of the rectal lumen. This disease probably occurs with equal frequency in temperate and tropical climates. It occurs more frequently in the white race than has been suspected. Just as in syphilis, this disease occurs in people in all walks of life. The course of the stricture is very chronic; the average duration in our cases was eight years. Although there is a remarkable uniformity in the microscopic findings, a positive diagnosis cannot be made from biopsy alone. The Frei test is specific for venereal lymphogranuloma. All rectal strictures require this test. No specific for the treatment of rectal strictures due to venereal lymphogranuloma has been reported. We believe that these patients must eventually submit to colostomy.

The Treatment of Lymphopathia Venereum with Sodium Sulfanilyl Sulfanilate and Sodium Sulfanilate

The Treatment of Lymphopathia Venereum with Sodium Sulfanilyl Sulfanilate and Sodium Sulfanilate

THE GENITO‐ANO‐RECTAL SYNDROME (LYMPHOPATHIA VENEREUM)

Medical Journal of AustraliaVolume 2, Issue 21 p. 935-936 Correspondence THE GENITO-ANO-RECTAL SYNDROME (LYMPHOPATHIA VENEREUM) First published: 01 November 1937 https://doi.org/10.5694/j.1326-5377.1937.tb45170.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume2, Issue21November 1937Pages 935-936 RelatedInformation

EXTRAGENITAL LESIONS OF LYMPHOGRANULOMA INGUINALE

In 1913 Durand, Nicolas and Favre¹differentiated from inguinal adenitis due to chancroid, syphilis and tuberculosis a new venereal disease, which they called subacute inguinal lymphogranulomatosis and which they established as a venereal disease entity. This disease has been variously referred to in the literature as a climatic bubo, tropical bubo, nonvenereal bubo, subacute inguinal periadenitis, fourth venereal disease, strumous bubo of the groin, nontuberculous lymphadenitis, subacute lymphadenitis, malady Nicolas-Favre, hypertrophic bubo and lymphopathia venereum. The primary lesion on the glans penis, in the vagina or elsewhere may be trivial and evanescent and may entirely escape notice. During an incubation period of from ten to thirty days²inguinal adenitis may develop, and this may result in suppuration. In 1925 Frei³announced an intradermal skin test, now known as the Frei test, which is characterized by an intradermal nodule appearing from thirty-six to seventy-two hours after injection into