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fear of unrecognized LGV

I m MSM in Europe (Ger) and visited a Brazilian escort service in February who gets around a lot in Europe. He confirms he is HIV neg, and usually careful and tested regulary. I bottomed, he used a condom, but also a lot of spit (directly inside) because we had not much lube. 3 days after, I got a very itchy spot in that area, I thought of bedbug bite but now from memory looks like herpes pix on the internet. It vanished quickly without problem.
4 weeks later, serious rectal trouble began. The rectum seems to be always full, there is an urge to go to toilet every time, even if there is nothing. If going to toilet is successful, there is diarrhoea, the stool is virtually liquid. That's for two months now, having to go to toilet apprx 10 times a day.
I went to several doctors, there has even be a complete coloscopy! Negative, everything fine to the doctors! I did a extensive swab / blood STD test at the local health office. Everything "ok", which is very disturbing considering symptoms persist.
1.) My first doc ignored my STD worries, suspected a serious bacterial infection and gave me Ciprofloxacin 500 for 5 days, 2 pills a day, not based on any examination results ("That should kill the most likely stuff."). I did those STD tests at the health office after 2 days ( = 4 pills ) of this antibiotic cycle. Could this lead to a false-negative PCR Chlamydia result of the rectal swab, while LGV bacteria still persisting in the lymph nodes?
2.) Since I feel there is permanently some kind of (external?) pressure on the rectum, could a CT scan of the bowl pay off? Maybe recognizing LGV affected lymph nodes? Another tests giving hints?
3.) Assuming I have LGV which does not get diagnosed and treated, is the "tertiary stage" with severe rectum injuries unavoidable? I'm 40, no other health problems. When I read descriptions of LGV, I wonder if the secondary stage also has symptom-free phases or the affected lymph nodes somehow calm down somewhen. Thank you.
1 Responses
936016 tn?1332765604
MEDICAL PROFESSIONAL
Hello and thanks for the post.

Lymphogranuloma venereum - LGV - is a chlamydial infection and can affect the anal canal and can be difficult to diagnose.

I'm not sure from what you have said which STD tests you have had and how they were done.

LGV of the anus and rectum will often give a typical feel to a doctor experienced in this area finger. Rectal syphilis can also be similar lesion.

My routine with this sort of scenario would be to take PCR swabs from rectum (and mouth / penis) looking for chlamydia and gonorrhoea, as well as testing for syphilis using PCR swabs and blood tests and also appropriate interval HIV testing (I understand a condom was used but HIV can arise from previous encounters and be relevant) together with plain bacterial swabs.

If all these are negative then testing for parasites like giardia may be useful.

In the situations where you have negative testing but remaining symptoms then a trail of metronidazole and ciprofloxacin may be useful.

If all this remains elusive and you are still troubled then a colonoscopy with biopsies may reveal a minor colitis which can respond to other specific types of treatment.

I'm not sure that CT or MRI will be terribly helpful but they are tests we use as we exhaust all the others.

Overall it sounds as though you should find a doctor you can be open with and who you get on with and work logically through a sequence to sort out.

kind regards, Sean
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