管理淋巴肉芽肿患者的临床经验。

X. Plakhova, G.L. Katunin, N. Abuduyev, M. M. Vasiliev
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摘要

文章介绍了两例具有典型表现的淋巴肉芽肿性病临床病例。在第一个病例中,可以追溯到淋巴肉芽肿性病的各个阶段:出现原发感染(阴茎溃疡),数周后发展为区域(腹股沟)淋巴结炎和直肠炎(肛门直肠综合征)。在按照 "强力霉素,剂量为 100 毫克,每天两次,持续 21 天 "的方案进行抗生素治疗后,临床表现完全消失。第二个病例的有趣之处在于,淋巴肉芽肿的临床表现从疾病的第二阶段(腹股沟综合征)开始发展,多西环素治疗无效,随后需要进行手术治疗。此外,在该病例中,最初在尿道刮片中检测到沙眼衣原体 DNA,但没有尿道炎症的证据,这在该疾病中十分罕见。为了治疗作为淋巴肉芽肿临床表现的 "腹股沟综合征 "患者,成功使用了氟喹诺酮类抗生素左氧氟沙星,疗程如下:500 毫克,每天两次,28 天为一疗程:每天两次,每次 500 毫克,持续 28 天。
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Clinical experience in managing patients with lymphogranuloma venereum.
The article presents two clinical cases of lymphogranuloma venereum with classic manifestations of the disease. In the first case, the stages of lymphogranuloma venereum can be traced: the appearance of a primary affect (ulcer on the penis), the development after a few weeks of regional (inguinal) lymphadenitis and proctitis (anorectal syndrome). On the background of prescribed antibiotic therapy according to the regimen: doxycycline at a dose of 100 mg twice a day for 21 days, the clinical manifestations completely resolved. The second case is interesting in the development of the clinical picture of lymphogranuloma venereum from the second stage of the disease (inguinal syndrome) and the ineffectiveness of treatment with doxycycline, which subsequently required surgical intervention. In addition, in this case, Chlamydia trachomatis DNA was initially detected in a urethral scraping without evidence of urethral inflammation, which is rare for this disease. To treat a patient with “groin syndrome” as a clinical manifestation of lymphogranuloma venereum, a fluoroquinolone antibiotic, levofloxacin, was successfully used according to the regimen: 500 mg twice a day for 28 days.
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