Criteria
Centers for Disease Control and Prevention[30]
The diagnosis of LGV is based on the clinical findings in combination with a supportive confirmatory test, such as the identification of Chlamydia trachomatis by nucleic acid amplification test, polymerase chain reaction-based genotyping, or Chlamydia serology (complement fixation titres). The diagnosis is also supported by epidemiological information and exclusion of other causes of genital ulcers, regional lymphadenopathy, or proctocolitis. Serological testing alone is not sufficient, but in combination with the appropriate clinical context, a complement fixation titre of greater than 1:64 may also support the diagnosis of LGV.
International Union against Sexually Transmitted Infections[1]
The diagnosis of LGV is confirmed by the detection of genovar-specific Chlamydia trachomatis DNA in specimens obtained from the site of infection (e.g., ulcer material from primary anogenital lesions, anorectal swabs from proctoscopic examination, or bubo aspirates). If modern laboratories are available, testing follows a two-step procedure: nucleic acid amplification test (NAAT) screening for C trachomatis then, if positive, NAAT is used to detect LGV genovar-specific DNA. If molecular diagnostic test facilities are not available, then a presumptive LGV diagnosis can be made using Chlamydia genus-specific serological assays. A high antibody titre (especially IgA anti-major outer membrane protein antibodies) in a patient with a clinical syndrome suggestive of LGV supports the diagnosis.[42] A low titre, however, does not exclude LGV infection, nor does a high titre in a patient without LGV symptomatology confirm LGV.
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