LGV (Lymphogranuloma venereum)
What is it?
LGV is short for Lymphogranuloma venereum. It is an infection of the urinary tract and/or of the throat and rectum. It is a form of the common sexually transmitted bacterial infection chlamydia caused by Chlamydia trachomatis (serovars L1, L2, L3).
It is very common in Africa, Asia, South America and parts of the Caribbean. It rarely occurs in industrialized countries but there is an increase in cases in these countries recently especially among men who have sex with men (MSM).
How it is spread?
It is spread by anal, oral or vaginal sex without condom. A person is infectious until they have finished their treatment, regardless of whether or not they have symptoms. LGV can affect the penis, vagina and anus.
What are the symptoms?
Symptoms are categorized in three stages:
Primary LGV:
- Symptoms can occurs between three to 30 days after infection.
- Small painless bump, which may open up, often at the head of the penis in men or in the vagina or on the cervix in women. There may be several of them.
- There may be some burning with urination.
- Initial symptoms may often go unnoticed if not in a place that is visible.
- Ulcers may heals and patients may have no more symptoms until the secondary stage.
Secondary LGV:
- Symptoms can occur between two to six weeks after primary ulcer heals.
- Painful lumps in groin (lymph nodes), most often on one side but may occur on both sides of the groin. If infection is in the throat, the person may have swollen lymph nodes in the neck.
- Lymph nodes may drain pus to the skin.
- Fever, chills, muscles pain and fatigue are other symptoms.
Tertiary LGV:
- Occurs in 25 per cent of patients.
- More common in men and women who receive anal sex.
- Symptoms include pus, blood and/or mucous from the anus and pain on bowel movements.
How it is diagnosed?
The most common means of detecting LGV is through a blood test and a swab of the affected site (urethral, rectal or vaginal).
What are the complications?
Untreated, LGV in men can cause chronic draining and scarring, elephantiasis (swollen legs), scrotal and penile swelling. In women, it can cause salpingitis (inflammation of the uterine tubes), infertility and scarring of the labia.
How is it treated?
LGV is treated with antibiotics (such as doxycycline, erythromycin and azithromycin). It is important that you take all the pills as directed even if the symptoms have disappeared. Treatment decreases the rate of complications but doesn’t accelerate the healing process. Pregnant women can be treated with erythromycin that is safe during pregnancy.
What about sexual partners?
All sexual partners within the past two months should be examined and treated. They should be treated even if their test result is negative. If your partner(s) are not having symptoms it does not mean that they do not have Chlamydia.
Follow up
Individuals should follow up with their doctor until symptoms have resolved. Do not have oral, vaginal or anal sex (even with a condom) while you and your partner are being treated.
Prevention
Using a condom every time you have sex will greatly reduce your chances of getting Chlamydia and other sexually transmitted infections.
