We present the case of a 66-year-old bisexual patient suffering from painful bloody defecation, linked to rectal thickening, rectovesical fistula and enlarged lymph nodes in the mesorectal area. The patient was misdiagnosed with rectal cancer (T3 N2) on MRI but the symptoms of the patient were due to lymphogranuloma venereum. After adequate treatment with doxycycline, symptoms faded within days; a control MRI showed complete regression of all pathologic alterations.
ZeidmanJAShellitoPCDavisBT, et al.A 33-year-old man with rectal pain and bleeding. NEJM2016; 357: 676–682.
2.
Lesiak-MarkowiczISchöttaAMStockingerH, et al.Chlamydia trachomatis serovars in urogenital and ocular samples collected 2014–2017 from Austrian patients. Sci Rep2019; 9: 18327.
3.
StaryGStaryA.Lymphogranuloma venereum outbreak in Europe. J Dtsch Dermatol Ges2008; 6: 935–939.
4.
de VriesHJVde BarbeyracBde VriezeNHN, et al.2019 European guideline on the management of lymphogranuloma venereum. J Eur Acad Dermatol Venereol2019; 33: 1821–1828.
5.
ColeMJFieldNPittR, et al.Substantial underdiagnosis of lymphogranuloma venereum in men who have sex with men in Europe: preliminary findings from a multicentre surveillance pilot. Sex Transm Infect2020; 96: 137–142.
6.
LevyIGefen-HaleviSNissanI, et al.Delayed diagnosis of colorectal sexually transmitted diseases due to their resemblance to inflammatory bowel diseases.Int J Infect Dis2018; 75: 34–38.
7.
HokkanenSRBoxallNKhalidJM, et al.Prevalence of anal fistula in the United Kingdom. World J Clin Cases2019; 7: 1795–1804.
8.
LynchCMFelderTLSchwandtRA, et al.Lymphogranuloma venereum presenting as a rectovaginal fistula. Infect Dis Obstet Gynecol1999; 7: 199–201.