DEAR DR. DONOHUE: I read an article about a strain of chlamydia that infects gay men. It says that the infection is slowly spreading among gay men here. It is called LGV chlamydia and is sexually transmitted. It has caused a worrisome outbreak in Europe, and diagnosis of it has been confirmed in the United States.

I ask because my son is gay and lives with another man. I did not know he was gay until recently. He has been married three times. He has had an infection in his jaw and ear. Please answer this, as I am all alone and don’t have any other relatives. – M.F.

ANSWER:
Chlamydia (cluh-MID-ee-uh) is a special kind of bacterium. It’s no stranger to these shores. One strain of this germ causes a common sexually transmitted disease that gives rise to a penile discharge in men and a vaginal discharge in women. Infection with this strain doesn’t always produce symptoms, and that creates problems in eradicating the germ and keeping the infection rate low.

The article you mention is about another chlamydia strain that causes a different sexually transmitted disease, lymphogranuloma venereum – LGV. It’s not a new infection. It’s seen most frequently in Africa, India, Southeast Asia, South America and the Caribbean.

LGV produces a sore or small lump on the genitals of men and women. Then, groin lymph nodes enlarge. It can also infect the rectum to cause proctitis, an inflammation of the rectal tissues.

This is the kind of infection that the article referred to, and most cases here have involved male homosexuals who are infected with the AIDS virus. A course of the antibiotic doxycycline can usually cure LGV.

Your son doesn’t have LGV. Jaw and ear infections are not signs of it. He is unlikely ever to catch LGV, since he is in a monogamous relationship with one other person.

DEAR DR. DONOHUE: A letter in one of your columns was from a mother whose son developed diarrhea from antibiotics. My husband and a friend of his had a similar problem. My husband was put on antibiotics for bronchitis. He developed watery diarrhea. He lost 20 pounds. I took him to a hospital, where our son-in-law is a doctor. An infectious-disease specialist at the hospital found the cause – clostridium toxin. He prescribed Flagyl, and my husband was better in short order. My husband’s friend suffered the same thing. People should know about this. – D.S.

DEAR DR. DONOHUE: Please explain Clostridium difficile. My cousin was hospitalized with it for a long time. – T.W.

ANSWER:
The digestive tract has a large number of bacteria living in it, doing no harm. Those residents ward off unfriendly bacteria, one of which is Clostridium difficile. Antibiotics can sometimes kill off many of the resident intestinal bacteria. That gives a chance for the Clostridium difficile (klos-TRID-ee-um dif-uh-SEAL) germ to stake a claim to real estate in the digestive tract. The clostridium begins to multiply and to produce a toxin that leads to profuse, watery diarrhea, stomach pains and a rise in body temperature. The illness can be nothing more than a short-lived nuisance, or it can be so overwhelming that it proves lethal.

Stopping the antibiotic often stops the diarrhea. When it doesn’t, either of two antibiotics usually can – one is Flagyl (metronidazole) and the other is vancomycin.

DEAR DR. DONOHUE: My 44-year-old sister was just diagnosed with a VIPoma. I can’t find much about it. Can you provide information? – J.M.

ANSWER:
Your sister has a most unusual tumor. Less than one person in a million ever comes down with a VIPoma. It’s a tumor that secretes VIP, vasoactive intestinal peptide, a hormone that dilates blood vessels and promotes the influx of huge volumes of fluid into the intestine. That, in turn, leads to watery diarrhea, a loss of body potassium and dehydration.

The tumor is, most of the time, found in the pancreas. About 40 percent to 70 percent of VIPomas are malignant. They can spread to distant body sites and organs.

Surgical removal, when possible, is the treatment of choice. When it’s not possible, Sandostatin is a medicine that can counteract the VIP hormone.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com


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