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Lymphogranuloma venereum(LGV): Treatment, symptoms, advice and help

About lymphogranuloma venereum

It is a sexually transmitted disease caused Chlamydia trachomatis that primarily infects the lymphatics.

Lymphogranuloma venereum: Incidence, age and sex

It is seen commonly in East/West Africa, India, South-east Asia, South America and the Caribbean.

LGV is diagnosed in men up to 6 times more frequently than in women and is most common in the second and third decades when sexual activity is highest.

Signs & symptoms of lymphogranuloma venereum

It begins as a small, transient, painless ulcer, vesicle or papule; often unnoticed. There are tender, usually unilateral matted, adherent, multiocular, suppurative inguinal / femoral nodes. If the route was anal sex, the infected person may develop proctitis with ano-rectal pain, tenesmus, and rectal discharge, or proctocolitis, associated with diarrhoea or abdominal cramps. In females, cervicitis, perimetritis, or salpingitis may occur as well as lymphangitis and lymphadenitis in deeper nodes. Systemic signs which can appear include high temperature, decreased appetite, and malaise. Diagnosis is more difficult in women and men who have sex with men (MSM) who may not have the inguinal symptoms.

Investigations: Serological test for L 1 – 3 serotypes; swab from ulcer or bubo pus for Chlamydia.

Causes and prevention of lymphogranuloma venereum

LGV is caused by Chlamydia trachomatis types L1, 2,3. It is a sexually transmitted disease. Prevention is by using a condom or other barrier methods.

Lymphogranuloma venereum: Complications

The lymph nodes may enlarge, and become painful and progress to necrosis with fluctuant and suppurative lymph nodes, abscesses, fistulas, strictures, and sinus tracts. When healing takes place, fibrosis may occur leading to lymphatic obstruction, chronic edema, and genital elephantiasis Fistulas of the penis, urethra, vagina, uterus, or rectum as well as rectal or other strictures and scarring can be seen as late complications. Systemic spread may occur resulting in arthritis, pneumonitis, hepatitis, or perihepatitis.