Lymphogranuloma venereum

Alternative names:

LGV; lymphogranuloma inguinale; lymphopathia venereum

Definition:

A sexually-transmitted disease causing inflammation and drainage of the inguinal and lower abdominal lymph nodes, and destruction and scarring of surrounding tissue. These enlarged nodes are called buboes.

Causes, incidence, and risk factors:

Lymphogranuloma venereum (LVG) is caused by three subtypes of Chlamydia trachomatis and is separate from the types that cause eye disease, blindness and the more common genital chlamydia.

Lymphogranuloma venereum is more common in Central and South America than in North America. LVG has a variable incubation period ranging from a few days to a month.

It begins as a painless ulcer on the male genitalia or in the female genital tract. As the organism spreads, the inguinal lymph nodes swell, become tender and attached to the surrounding tissue (fixed), and finally rupture and drain through the skin. The skin above the lymph node is often swollen (edematous) and red. These areas may appear to heal, but the patient will have relapses of lymph node swelling and drainage. The patient may also have systemic signs including fever, decreased appetite, and malaise.

In homosexual men and women who practice anal intercourse the disease produces lymph node swelling around the rectum (perirectal). This is often accompanied by bloody rectal discharge, painful defecation (tenesmus), diarrhea and lower abdominal pain. Women may develop fistulas between the vagina and rectum.