Definition of Lymphogranuloma venereum:

Lymphogranuloma venereum (LGV) is a sexually transmitted disease (STD) caused by the bacteria Chlamydia trachomatis.

Causes, incidence, and risk factors:

Lymphogranuloma venereum (LGV) is caused by three different sub-types of the bacteria Chlamydia trachomatis. The bacteria is spread through sexual contact. (Note: This infection is caused by a different bacteria than the more common genital chlamydia.)

Symptoms of LGV can begin a few days to a month after becoming infected. It 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. The main risk factor is having multiple sexual partners.

The disease starts as a painless ulcer on the male genitalia or in the female genital tract. As the bacteria spreads, lymph nodes in the area become swollen and tender. The skin around the area is often red. The swollen lymph nodes (buboes) may break open and drain through the skin.

In people who have anal intercourse, the disease can affect the lymph nodes around the rectum (perirectal). The infection is often associated with bloody rectal discharge, painful bowel movement (tenesmus), diarrhea, and lower abdominal pain. Women may develop fistulas (connections) between the vagina and rectum.

Symptoms:

• Small painless ulcer on genitalia
• Swelling and redness of the skin in the groin area
• Swollen groin lymph nodes on one or both sides
• Drainage from lymph nodes in groin
• Blood or pus from the rectum (blood in the stools)
• Pain while having a bowel movement (tenesmus)

Signs and tests:

The medical history and physical examination may show:

• A history of sexual contact with a person having lymphogranuloma venereum
• An ulcer on an affected person's genitals
• A perianal fistula with drainage
• Swollen lymph nodes in the groin (inguinal lymphadenopathy)
• Drainage from lymph nodes in the groin

• Biopsy of the node
• Indirect immunofluorescence for chlamydia
• Serology test for LGV

Treatment:

Lymphogranuloma venereum can be cured by proper antibiotic therapy. Commonly prescribed medications include tetracycline, doxycycline, and erythromycin.

Expectations (prognosis):

With treatment, the outlook is good.

Complications:

• Scarring and narrowing of the rectum
• Long-term inflammation and swelling of the genitalia
• Rectovaginal fistula (an opening between the rectum and vagina)
• Meningoencephalitis (brain inflammation), very rare

Calling your health care provider:

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 getting a sexually-transmitted disease. The condom should be in place from the beginning to end of sexual activity.