LAUSR

L ymphogranuloma venereum (LGV) has reemerged as a common rectal infection in men who have sex with men (MSM). Martinez et al described the excellent performance of two recently developed commercial genotyping assays to diagnose rectal infection with the LGV biovars of Chlamydia trachomatis. Expanded availability of LGV genotyping will promote research and surveillance, and the authors suggest it also will benefit clinical management by guiding the duration of treatment. Guidelines for LGV treatment for the European Union and the United States advice 21-day courses of doxycycline. However, recent data suggest that 7 day regimens of doxycycline suffice for many rectal infections with LGV biovars, which may reduce the need for routine genotyping of rectal chlamydia. In 60 MSM in London with rectal LGV biovar infection treated before their genotyping results were known, Simons et al reported cure of 59 men (97%) with 7to 14-day courses of doxycycline (100 mg twice daily), including 38 (97%) of 39 men treated for 7 days. Most such infections are asymptomatic or clinically mild, with clinical presentations similar to those of rectal infection with non-LGV C. trachomatis,