Lymphogranuloma venereum (LGV)

Abbreviated LGV. An uncommon genital or anorectal (affecting the anus and/or rectum) infection that is caused by a specific type of Chlamydia trachomatis.

Patients typically have tender glands (lymph nodes) in the groin and may recently have had a genital ulcer that resolved on its own. Other patients, in particular those with HIV infection, may have rectal or anal inflammation, scarring, and narrowing (stricture), which cause frequent small bowel movements (diarrhea) and a sense of incomplete evacuation of the bowels. In addition, these patients can have pain around the anal area (perianal), and occasionally drainage from the perianal area or the glands in the groin.

The diagnosis of lymphogranuloma venereum is suspected in a person with typical symptoms and in whom other causes (such as chancroid, herpes, and syphilis) have been excluded. The diagnosis in such a patient is usually made by a blood test that detects specific antibodies to Chlamydia, which are produced as part of the body’s immunological (defensive) response to that bacterial organism.

Once lymphogranuloma venereum is diagnosed, it is usually treated with doxycycline 100 mg twice per day by mouth for 21 days. If this is not an option, for example, because of intolerance to the drug, azithromycin 2g in one dose can be used as an alternative.

A person who has been sexually exposed to a person with lymphogranuloma venereum should be examined for signs or symptoms of lymphogranuloma venereum, as well as for chlamydial infection of the urethra, since the lymphogranuloma venereum and urethral strains (types) of Chlamydia trachomatis can co-exist. If exposure occurred within 30 days of the onset of their partner’s symptoms of lymphogranuloma venereum, the exposed person should be treated.