Khoury KM, Jradi A, Karam K, Fiani E. Lymphogranuloma venereum proctosigmoiditis misdiagnosed as inflammatory bowel disease: A case report. World J Clin Cases 2025; 13(14): 102791 [DOI: 10.12998/wjcc.v13.i14.102791]
Corresponding Author of This Article
Elias Fiani, Department of Gastroenterology and Hepatology, University of Balamand, Dekweneh, Beirut 100, Beyrouth, Lebanon. elias.fiani@hotmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. May 16, 2025; 13(14): 102791 Published online May 16, 2025. doi: 10.12998/wjcc.v13.i14.102791
Lymphogranuloma venereum proctosigmoiditis misdiagnosed as inflammatory bowel disease: A case report
Kaline Maya Khoury, Ahmad Jradi, Karam Karam, Elias Fiani
Kaline Maya Khoury, Ahmad Jradi, Department of Internal Medicine, University of Balamand, Beirut 100, Beyrouth, Lebanon
Karam Karam, Department of Gastroenterology, University of Balamand, Beirut 100, Beyrouth, Lebanon
Elias Fiani, Department of Gastroenterology and Hepatology, University of Balamand, Beirut 100, Beyrouth, Lebanon
Co-first authors: Kaline Maya Khoury and Ahmad Jradi.
Co-corresponding authors: Karam Karam and Elias Fiani.
Author contributions: Maya KK and Ahmad J performed the literature review with data curation, investigation and writing original draft; Karam K and Fiani E performed editing of the first draft, investigation and supervising the work of first co-authors.
Informed consent statement: A signed written informed consent was obtained from the patient prior to writing the manuscript.
Conflict-of-interest statement: The authors declare no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Elias Fiani, Department of Gastroenterology and Hepatology, University of Balamand, Dekweneh, Beirut 100, Beyrouth, Lebanon. elias.fiani@hotmail.com
Received: October 29, 2024 Revised: December 20, 2024 Accepted: January 7, 2025 Published online: May 16, 2025 Processing time: 78 Days and 15.4 Hours
Abstract
BACKGROUND
There has been a rise in the number of cases diagnosed as lymphogranuloma venereum (LGV), caused by the transmission of Chlamydia trachomatis, specifically serotypes L1, L2, and L3, mostly in men who have sex with men (MSM). LGV can clinically manifest as rectal discomfort, bleeding, and mucoid discharge mimicking inflammatory bowel disease (IBD). Therefore, the role of a wholesome collection of patient history along with gaining patient trust and ease in reporting different elements of their life— whether social or sexual history-could greatly guide physician’s investigations leading to timely and more efficient diagnosis.
CASE SUMMARY
A 38-year-old male presenting with symptoms of rectal bleeding, mucoid discharge, and abdominal pain during the past month. Initial treatment for hemorrhoids given at an outpatient clinic did not improve the patient’s complaints warranting further examinations, whereby endoscopy revealed the presence of mucosal edema and ulcerations in the rectosigmoid area rendering IBD a plausible diagnosis theoretically, but practically refuted due to the negative biopsy results, and positive result of nucleic acid amplification testing of the rectal swab sample for Chlamydia trachomatis. The latter results are in accordance with the diagnosis of LGV proctosigmoiditis. Accordingly, medical therapy with doxycycline was instituted, which yielded a notable symptomatic relief, and an education on safe sexual practices.
CONCLUSION
LGV proctosigmoiditis is a crucial differential diagnosis in high risk patients, such as MSM that should be differentiated from IBD. Obtaining a thorough sexual history is pivotal to prevent misdiagnosis and guarantee prompt, effective therapy.
Core Tip: Lymphogranuloma venereum (LGV) should be considered as one of the differential diagnosis when confronting a patient with rectal symptoms to avoid misdiagnosis and needless treatments. Differentiating between LGV and inflammatory bowel disease can be challenging due to their similarity in clinical, endoscopic, and histopathological features especially in patients whom sexual history is not known. Our case illustrates the importance of sexual history in our diagnostic approach and the urge for clinicians to increase awareness of LGV among high risk populations.
