Lymphogranuloma venereum
Definition
Lymphogranuloma venereum (LGV) is a sexually transmitted bacterial infection.
Alternative Names
LGV; Lymphogranuloma inguinale; Lymphopathia venereum
Causes
Lymphogranuloma venereum (LGV) is caused by three different types of the bacteria Chlamydia trachomatis. The bacteria is spread through sexual contact. However, this infection is caused by a different bacteria than that which causes genital chlamydia.
LGV is more common in Central and South America than in North America. There are a few thousand cases of LGV each year in the United States.
LGV is more common in men than women. The main risk factor is having multiple sexual partners.
Symptoms
Symptoms of LGV can begin a few days to a month after coming in contact with the bacteria. Symptoms include:
- Small painless ulcer on the male genitalia or in the female genital tract
- Swelling and redness of the skin in the groin area
- Swollen groin lymph nodes on one or both sides; it may also affect lymph nodes around the rectum in those who have anal intercourse
- Drainage from lymph nodes in groin
- Blood or pus from the rectum (blood in the stools)
- Painful bowel movements (tenesmus)
The infection can cause diarrhea and lower abdominal pain. Women may develop abnormal connections called fistulas between the vagina and rectum.
Exams and Tests
The health care provider will perform a physical examination and ask questions about your medical history. It is important to tell your doctor if you had sexual contact with someone who has had lymphogranuloma venereum.
A physical exam may show:
- An ulcer on the genitals
- An oozing, abnormal connection (fisula) in the rectal area
- Swollen lymph nodes in the groin (inguinal lymphadenopathy)
- Drainage from lymph nodes in the groin
Tests may include:
- Biopsy of the lymph node
- Blood test for the bacteria that causes LGV
- Laboratory test to detect chlamydia
Treatment
This condition can be cured with the proper antibiotics. Those commonly prescribed to treat LGV include tetracycline, doxycycline, and erythromycin.
Outlook (Prognosis)
With treatment, the outlook is good.
Possible Complications
- Abnormal connections of tissue between the rectum and vagina
- Brain inflammation (very rare)
- Long-term inflammation and swelling of the genitalia
- Scarring and narrowing of the rectum
When to Contact a Medical Professional
Call your health care provider if you have been in contact with someone who may a sexually transmitted disease, including LVG. Also call if symptoms of LVG develop.
Prevention
Abstaining from sexual activity is the only absolute way to prevent a sexually transmitted disease. Safer sex behaviors may reduce the risk.
The proper use of condoms, either the male or female type, greatly decreases the risk of catching a sexually transmitted disease. You need to wear the condom from the beginning to the end of each sexual activity.
References
Stamm WE, Jones RB, Batteiger BE. Chlamydia trachomatis (trachoma, perinatal infections, lymphogranuloma venereum, and other genital infections). In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 6th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2005:chap 177.
Eckert LO, Lentz GM. Infections of the lower genital tract: vulva, vagina, cervix, toxic shock syndrome, HIV infections. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 22.
Centers for Disease Control and Prevention, Workowski KA, Berman SM. Diseases characterized by genital ulcers. Sexually transmitted diseases treatment guidelines 2006. MMWR Morb Mortal Wkly Rep. 2006 Aug 4;55(RR-11):14-30.
Review Date:
10/28/2008
Reviewed By:
Linda Vorvick, MD, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington ; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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