Lymphogranuloma Venereum

Lymphogranuloma venereum (LGV) is a systemic, sexually transmitted disease (STD) caused by a type of Chlamydia trachomatis. Although it rarely occurs in the United States and other industrialized countries, the Netherlands and other European countries have reported increases in LGV proctitis among men who have sex with men (MSM). The majority of patients with LGV proctitis in the U.S. have been HIV-infected MSM.

Other Names

 * Durand-Nicolas-Favre disease
 * Lymphopathia venerea
 * Climatic, strumous, and tropical bubo
 * Poradenitis inguinales
 * Lymphogranuloma inguinale

Signs and Symptoms
Symptoms of LGV include:
 * Mucoid/purulent anal discharge
 * Rectal bleeding
 * Constipation
 * Genital or rectal ulcer
 * Anal spasms

Causes
Lymphogranuloma venereum (LGV) is caused by serovars L1, L2, and L3 of the obligate intracellular bacterium Chlamydia trachomatis. These LGV strains are more virulent in animal models than the more prevalent serovars A–K of C. trachomatis, and more invasive in humans. Serovars A–K are largely confined to cells in the upper layers of the lining of the genital tract and eye. Serovars L1, L2, and L3 infect predominantly monocytes and macrophages (both are types of white blood cells), pass through the epithelial surface to regional lymph nodes, and may cause disseminated infection.

Treatment
Effective treatments are available. Diagnosis of this STD usually includes a blood test (which looks for the presence of the chlamydia bacteria) and a needle biopsy of infected lymph glands. Treatment involves oral antibiotics, including:
 * Tetracycline
 * Doxycycline
 * Erythromycin

These antibiotics are taken daily for three weeks, or until the infection has cleared.

Chances of Developing
LGV is a rare disease in Europe and North America, but is endemic in parts of Africa, Asia, South America, and the Caribbean. Its epidemiology is poorly defined, since it cannot be distinguished clinically from other causes of genital ulceration and it is difficult to diagnose with confidence in the laboratory.

The general population is at low risk for contracting lymphogranuloma venereum. The risk of contracting the disease increases if you:
 * Are or engage in sexual contact with men who have sex with men (MSM)
 * Have multiple sexual partners
 * Engage in unprotected sex
 * Frequently visit areas where the infection is endemic

How is Spread
Lymphogranuloma venereum is transmitted through skin-to-skin contact with an infected person. Sexual contact is the most common method of transmission. A person can become infected by participating in:
 * Vaginal intercourse
 * Anal intercourse
 * Oral intercourse
 * Mutual masturbation