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Lymphogranuloma venereum

Lymphogranuloma venereum (LGV) is a sexually transmitted bacterial infection.

Causes

Lymphogranuloma venereum (LGV) is a chronic (long-term) infection of the lymphatic system. It is caused by any of three different types (serovars) of the bacterium Chlamydia trachomatis. The bacteria spread by sexual contact. The infection is not caused by the same bacteria that cause genital chlamydia.

LGV is more common in Central and South America than in North America.

LGV is more common in men than women. The main risk factor is being HIV-positive.

Symptoms

Symptoms of LGV can begin a few days to a month after coming in contact with the bacteria. Symptoms include:

  • Drainage through the skin from lymph nodes in the groin
  • Painful bowel movements (tenesmus)
  • Small painless sore on the male genitals or in the female genital tract
  • Swelling and redness of the skin in the groin area
  • Swelling of the labia (in women)
  • Swollen groin lymph nodes on one or both sides; it may also affect lymph nodes around the rectum in people who have anal intercourse
  • Blood or pus from the rectum (blood in the stools)  

The infection can cause diarrhea and lower abdominal pain.

Exams and Tests

The health care provider will examine you and ask about your medical and sexual history. Always tell your health care provider if you had sexual contact with someone who has had symptoms of LGV.

A physical exam may show:

  • An oozing, abnormal connection (fistula) in the rectal area
  • A sore on the genitals
  • Drainage through the skin from lymph nodes in the groin
  • Swelling of the vulva or labia in women
  • Swollen lymph nodes in the groin (inguinal lymphadenopathy)

Tests may include:

  • Biopsy of the lymph node
  • Blood test for the bacteria that causes LGV
  • Laboratory test to detect chlamydia

Treatment

LGV is treated with antibiotics.

Outlook (Prognosis)

With treatment, the outlook is good.

Possible Complications

  • Abnormal connections between the rectum and vagina (fistula)
  • Brain inflammation (encephalitis - very rare)
  • Infections in the joints, eyes, heart, or liver
  • Long-term inflammation and swelling of the genitals
  • Scarring and narrowing of the rectum

Complications can occur many years after you are first infected.

When to Contact a Medical Professional

Call your health care provider if:

  • You have been in contact with someone who may a sexually transmitted infection, including LGV
  • You develop symptoms of LGV

Prevention

Not having any sexual activity is the only way to prevent a sexually transmitted infection. 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 infection. You need to wear the condom from the beginning to the end of each sexual activity.

Alternative Names

LGV; Lymphogranuloma inguinale; Lymphopathia venereum

References

Batteiter BE, Tan M. Chlamydia trachomatis (trachoma, genital Infections, perinatal infections, and lymphogranuloma venereum). In: Bennett JE, Dolin R, Mandell GL, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 182.

Eckert LO, Lentz GM. Infections of the lower genital tract: vulva, vagina, cervix, toxic shock syndrome, endometritis, and salpingitis. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 23.

Update Date: 8/31/2014

Updated by: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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