A sexually transmitted disease (STD) that is caused by a bacterium called chlamydia trachomati and causes fluid-filled blisters on the genitals is called lymphogranuloma venereum (LGV). Without treatment, LGV may lead to serious complications. Commonly, doctors prescribe antibiotics to treat this STD.
When the disease advances, it may also cause painful and swollen lymph nodes in the groin area, pelvis, or rectum. Generally, LGV is more common in tropical and subtropical areas. It may also occur in the U.S., but is rare. In Europe, LGV occurs more frequently among men who have sex with men, but it still happens rarely. For example, 22 countries in Europe reported about 2,400 cases of LGV in 2018.
What Are The Symptoms of Lymphogranuloma Venereum?
Usually, symptoms appear within 12 days after exposure to the bacterium that causes this STD. Moreover, people with LGV experience different symptoms because they depend on the stage of the disease. Examples include:
First Stage Symptoms
People with the first stage of LGV can notice small blisters filled with fluid on the penile or in the vagina. They are often painless and heal quickly. In rare cases, this stage may cause sores in the mouth or throat.
Second Stage Symptoms
The following symptoms usually appear within 6 weeks after the previous stage. It often causes swollen, tender, and painful lymph nodes in the pelvic area, near the rectum (especially in women). Sometimes, the skin around these lymph nodes may break down, which increases the risk of secondary infections.
Third Stage Symptoms
The following symptoms usually occur when the infection is not properly treated. For example:
- Scars
- Abscesses
- Anal fistula
- Deformed genitals
- Rectal strictures (narrowing of the rectum)
- Swelling
- Pelvic floor dysfunction
LGV may also cause other symptoms that do not depend on which stage you have. Check some of them below:
- Constipation
- Abdominal, anal, pelvic, or back pain
- Extreme tiredness (fatigue)
- Body aches
- Proctitis (inflammation of the anus and rectum)
- Rectal bleeding, itching, or unusual discharge
- Dysuria (painful urination)
- Unusual weight loss
- Headaches
- Fever
Immediately contact your healthcare provider if any of the symptoms listed above occur. It is very important to get treatment as soon as possible to prevent serious complications.
Causes and Risk Factors
This STD is caused by a bacterium called chlamydia trachomatis. Usually, LGV occurs due to certain types of this bacterium (serovars, including L1, L2, and L3). A different type of chlamydia (such as serovars D-K) causes a more common STD called chlamydia. Moreover, LGV can easily spread from one person to another through anal, vaginal, or oral sex.
While anyone can develop this STD, physicians have found some factors that could increase your risk. Check some of them below:
- Unprotected anal or vaginal sex
- Multiple sexual partners
- Personal history of STDs
- Living or traveling to endemic areas
- HIV infection
- MSM ā Men who have sex with men
- Weakened immune system
- Other sexually transmitted infections (STIs), such as gonorrhea or hepatitis C
- Age ā People between the ages of 15 and 40 are at increased risk for LGV.
In addition, those who already have LGV are at increased risk for other STDs. These include gonorrhea, syphilis, HIV, and others.
What Happens if Lymphogranuloma Venereum is Left Untreated?
If you develop LGV and ignore the symptoms and do not get treatment, it may lead to the following complications. Examples include:
- Anal fistulas
- Lymphatic obstruction (blockage of the lymph fluids that go through the lymphatic system)
- Infertility
- Genital enlargement
- Reactive arthritis (joint disease caused by an infection)
- Elephantiasis (swelling of the genitals)
- Hepatitis
- Pneumonia
- Severe proctocolitis
This article does not contain a full list of LGV complications. However, your doctor may recommend some options to reduce the risk or even prevent them.
Is There a Way to Prevent Lymphogranuloma Venereum?
Usually, physicians recommend the following tips to reduce the risk of this STD. Examples include:
- Practice safe sex by using condoms or dental dams to prevent STIs
- Get treatment as soon as an STI occurs
- Get regular checkups (especially if you have multiple sexual partners)
Diagnosis
Like the diagnosis of many other health conditions, LGV diagnosis starts with a physical examination and questions about the symptoms and medical history. However, to exclude or confirm LGV, doctors will perform the following tests. These include:
- Blood tests ā These tests are done to check for antibodies against chlamydia trachomatis.
- NAAT (nucleic acid amplification test) ā During this test, doctors will take a sample of fluid from the groin, rectum, or lymph node to check for the bacterium that causes LGV.
Treatment
Most physicians prescribe Doxycycline (100 milligrams) twice a day for 21 days to treat LGV. Sometimes, doctors may prescribe Erythromycin or Azithromycin as an alternative. In more severe cases, your doctor may recommend a needle biopsy to drain pus-filled lymph nodes and relieve pain.
Frequently Asked Questions
Is lymphogranuloma venereum (LGV) the same as regular chlamydia?
No. LGV is caused by specific strains (including L1, L2, and L3) of the bacterium Chlamydia trachomatis. The more common form of chlamydia is usually caused by different strains (such as DāK) and generally causes milder symptoms than LGV.
Can LGV be cured?
Yes. LGV is curable with antibiotics when diagnosed and treated early. Doxycycline is one of the most common medicines used for people with LGV, and it is important to complete the entire course of antibiotics even if symptoms improve before treatment is finished. Otherwise, the condition may return, and it becomes more difficult to treat.
Can someone have LGV without noticeable symptoms?
Yes. Some people have very mild symptoms or none at all during the early stages of LGV. Even without symptoms, an infected person can still spread the infection to sexual partners.
Should my sexual partner be treated if I have LGV?
Yes. Recent sexual partners should be evaluated, tested, and treated if necessary, even if they do not have symptoms. This helps prevent reinfection and reduces the spread of the disease.
How long should I avoid sexual activity after starting treatment?
People with LGV should avoid all sexual activity until they have completed their prescribed antibiotic treatment, their symptoms have resolved, and their healthcare provider confirms it is safe to resume sexual activity. Partners should also be treated before sexual contact resumes.
Can LGV increase the risk of HIV infection?
Yes. The sores and inflammation caused by LGV can make it easier to acquire or transmit HIV during sexual contact. For this reason, healthcare providers often recommend testing for HIV and other sexually transmitted infections when LGV is diagnosed.
Can LGV come back after treatment?
Yes. Successful treatment eliminates the current infection, but it does not provide immunity. A person can become infected again after future exposure to the bacteria, making safer sex practices and regular STI screening important.
Who should be tested for LGV?
Testing is recommended for people with symptoms suggestive of LGV, those who have had sexual contact with someone diagnosed with LGV, and individuals at higher risk of sexually transmitted infections, especially men who have sex with men who develop rectal symptoms or swollen lymph nodes.
Is LGV contagious through casual contact?
No. LGV is not spread through casual contact such as hugging, shaking hands, sharing food, using the same toilet, or swimming in public pools. It is primarily transmitted through vaginal, anal, or oral sexual contact with an infected person.
Can untreated LGV cause permanent damage?
Without prompt treatment, LGV can lead to permanent complications, including scarring, chronic swelling of the genitals, rectal narrowing (strictures), fistulas, damage to the lymphatic system, and, in some cases, infertility. Early diagnosis and treatment greatly reduce the risk of these long-term complications. If you have additional questions, ask your healthcare professional.
