Last Updated: 2023-07-07
Author(s): Anzengruber F., Navarini A.
- Hunter 1786
- Durand, Favre & Nicolas 1913
- Frei 1925
Lymphogranuloma venereum, lymphogranulomatosis inguinalis, climatic bubo, fourth venereal disease.
Notifiable sexually transmitted disease caused by Chlamydia trachomatis serotype L1-L3
- Mostly found in the tropics and subtropics
- Males > females
Infection occurs through sexual intercourse.
After an incubation period of 1 to several weeks, skin changes occur in the area of the penis/vulva, cervix or portio.
With progression in 3 stages:
- Primary lesion, which may ulcerate as a painless papule/papulovesicle/papulopustule in the course. Serous secretion is discharged.
- After up to 4 weeks, there is marked dolent swelling in the groin area. The surface of the nodes is reddened with inflammation and abscess formation/perforation may occur
- 5-10 yrs after primary infection, genitorectal symptoms (swelling, elephantiasis, ulcers, strictures, bloody diarrhoea) and ↓ AZ may occur.
- Always treat your partner as well!
- Unprotected sexual intercourse?
- Ulcera genitoanal remembered?
- Swelling of the inguinal lymph nodes?
- Clinical picture
- Bact. Swab of the ulcer
- PCR of chlamydial DNA from tissue secretion or LK punctate
- Serology for antibody detection
- Chlamyidia antigen detection, (To confirm the diagnosis in suspected cases, an additional genotype determination should be carried out in a special laboratory)
- Stage I: Man: glans penis, coronary groove, prepuce, anterior urethral segment. Woman: vulva, vagina, cervix. In the current LGV epidemic in Europe and North America among MSM, the rectum represents the most common site of infection.
Stage II: Bubonic. After the appearance of the primary lesion, the inflammation spreads via the lymphatic system.
- Stage III: Genitoanal area
Elephantiasis genitoanorectalis ulcerosa and anorectal symtomal complex, abscesses, fistulas, strictures.
Use of condoms.
Good prognosis with early therapy (stages I and II). With pronounced stage III, residuals remain with fibrosis, elephanitasis genitalis and anorectal symptom complex.
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