Lymphogranuloma inguinale

Last Updated: 2023-07-07

Author(s): Anzengruber F., Navarini A.

ICD11: 1A80

  • 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:

Stage I:

  • Primary lesion, which may ulcerate as a painless papule/papulovesicle/papulopustule in the course. Serous secretion is discharged.

Stage II:

  • 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

Stage III:

  • 5-10 yrs after primary infection, genitorectal symptoms (swelling, elephantiasis, ulcers, strictures, bloody diarrhoea) and ↓ AZ may occur.

  • Always treat your partner as well!
  • Anamnesis
    • 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
  • Laboratory
    • 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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