Lymphogranuloma Venereum (LGV) is a sexually transmitted infection (STI) caused by an aggressive strain of the bacterium Chlamydia trachomatis.
LGV can be passed on through unprotected oral, vaginal or anal sex from a person who is infected. It can also be transmitted through fisting, sharing sex toys and having a new or multiple partners.
Signs and Symptoms
LGV has 3 stages of the infection:
Stage 1 can occur 3 to 30 days after the infection. You may notice a small painless sore at the site of the infection (rectum, penis, vagina or mouth), or you may notice nothing, as the sore can be hidden inside the rectum, vagina or throat. The sore will heal on its own and may go unnoticed in up to 50% of people with the infection.
Stage 2 usually occurs 2 to 6 weeks after stage 1. You may notice fever, chills, headaches and fatigue, along with painful swelling of the glands (lymph nodes) closest to the site of infection. A pus-filled swelling called bubo may be noticed in the groin area. If the infection is in the rectum, there may be blood, pus, pain or constipation. If the infection is in the vagina or penis there may be discharge. If the infection is in the mouth or throat, buboes may be located in the neck or armpits.
Stage 3 occurs without treatment and is more common in females than males. You may notice extreme swelling of the genitals, and/or abscesses. There may also be scarring or tissue damage leading to the narrowing of the rectum or vagina.
Diagnosis and Tests
The diagnosis of LGV is not simple, as the signs and symptoms are similar to other sexually transmitted infections (STIs). The diagnosis is often based on the sexual history, clinical findings and laboratory testing.
Depending on the stage of the infection, if a lesion is present, a doctor or nurse will collect a swab from the site of the infection (rectal, vaginal, throat or penis). They may also examine the inside of your anus, rectum and lower part of the large intestine (anoscopy, sigmoidoscopy, proctoscopy) to assess for inflammation, swelling, bleeding or pus. If a bubo is present, a sample of the fluid inside will be collected.
If the infection progresses to the third stage, tissue damage of the vagina, rectum or site of infection can occur, as the bacteria can lead to scarring. As a result, surgery may be required to repair the genital/rectal damage.
In rare cases, an untreated infection can cause damage to the spinal cord, brain and the surrounding membranes (meningoencephalitis). Untreated LGV can even lead to death.
LGV can be treated with 3 weeks of antibiotics. Follow-up should be ongoing until chlamydial tests are negative and no clinical symptoms remain.
It is easier to get or give HIV if you have untreated LGV because of the bleeding and sores. You may also be at higher risk for getting other STIs. Because of rates of co-infection, testing for HIV, syphilis, herpes, gonorrhea, hepatitis B and hepatitis C is recommended.
Here are a few important points to remember:
- Wash or cover sex toys in a new condom if sharing.
- If you think you are infected, avoid any sexual contact.
- Use condoms correctly every time you have sex to lower your chance of getting an STI.
Information for Sexual Partners
It is important to inform all of your sexual partners within the past 60 days, so that they can be tested and treated, regardless of whether they have symptoms. If you have not had sex in the past 2 months, then your last sexual partner should be tested and treated. Tell your partner(s) that having no symptoms does not mean there is no infection.
If you do not want to tell your partner(s), a public health nurse can notify them for you. Your name will be kept confidential.