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Lymphogranuloma venereum

LGV; Lymphogranuloma inguinale; Lymphopathia venereum

 

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

Causes

 

Lymphogranuloma venereum (LGV) is a long-term (chronic) infection of the lymphatic system. It is caused by any of 3 different types (serovars) of the bacteria Chlamydia trachomatis. The bacteria are 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)

 

Exams and Tests

 

The health care provider will examine you and ask about your medical and sexual history. Tell your provider if you had sexual contact with someone you think 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, including doxycycline and erythromycin.

 

Outlook (Prognosis)

 

With treatment, the outlook is good.

 

Possible Complications

 

Health problems that may result from LVG infection include:

  • 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 provider if:

  • You have been in contact with someone who may have 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.

 

 

References

Batteiger BE, Tan M. Chlamydia trachomatis (trachoma, genital Infections, perinatal infections, and lymphogranuloma venereum). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 182.

Eckert LO, Lentz GM. Infections of the lower and upper genital tracts: 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.

 
  • Lymphatic system

    Lymphatic system - illustration

    The lymphatic system filters fluid from around cells. It is an important part of the immune system. When people refer to swollen glands in the neck, they are usually referring to swollen lymph nodes. Common areas where lymph nodes can be easily felt, especially if they are enlarged, are: the groin, armpits (axilla), above the clavicle (supraclavicular), in the neck (cervical), and the back of the head just above hairline (occipital).

    Lymphatic system

    illustration

    • Lymphatic system

      Lymphatic system - illustration

      The lymphatic system filters fluid from around cells. It is an important part of the immune system. When people refer to swollen glands in the neck, they are usually referring to swollen lymph nodes. Common areas where lymph nodes can be easily felt, especially if they are enlarged, are: the groin, armpits (axilla), above the clavicle (supraclavicular), in the neck (cervical), and the back of the head just above hairline (occipital).

      Lymphatic system

      illustration

    Tests for Lymphogranuloma venereum

     

       

      Review Date: 9/10/2015

      Reviewed 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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