Last Updated: 2020-11-19
- Hunter 1786
- Durand, Favre u. Nicolas 1913
- Frei 1925
Lymphogranuloma venereum, lymphogranulomatosis inguinalis, climatic bubo, fourth venereal disease.
Notifiable sexually transmitted disease caused by Chlamydia trachomatis serotype L1-L3.
- Especially found in the tropics and subtropics.
- Men > Women.
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 a course in 3 stages:
- Primary lesion which may ulcerate as a painless papule/papulovesicle/papulopustule in the course of the disease. Serous secretion is evacuated.
- After up to 4 weeks there is pronounced dolent swelling in the groin area. The surface of the nodules is inflammatory reddened and abscess formation/perforation may occur.
- 5-10 years after the primary infection genito-rectal symptoms (swelling, elephantiasis, ulcers, strictures, bloody diarrhoea) and ↓ general condition may occur.
- Always co-treatment of the partner!
- Medical history
- Unprotected sexual intercourse?
- Genito-anal ulcers recall?
- Swelling of the inguinal lymph nodes?
- Clinical picture
- Bakt. Smear of the ulcer
- PCR of Chlamydia DNA from tissue secretion or LK puncture
- Serology for antibody detection
- Chlamyidia antigen detection, (To confirm the diagnosis in case of suspicion an additional genotype determination should be carried out in a special laboratory).
Stage I: Male: Glans penis, coronal furrow, prepuce, anterior urethral segment. Woman: Vulva, vagina, cervix. In the current LGV epidemic in Europe and North America under MSM, the rectum is the most common site of infection.
Stage II: Boils. After the appearance of the primary lesion, the inflammation spreads via the lymphatic system.
Stage III: Genitoanal area.
Elephantiasis genitoanorectalis ulcerosa and anorectal syndrome complex, abscesses, fistulas, strictures.
Use of condoms.
Good prognosis with early therapy (stage I and II). In pronounced stage III residuals with fibrosis, genital elephanitasis and anorectal symptom complex remain.
Always treat a partner as well!
Stage I and II
- Doxycycline p.o. 100 mg 2x daily for 21 days
- Erythromycin p.o. 500 mg 4x daily for 7-14 days
- Azithromycin 1.5g p.o. Day 1, 8 and 15
- For elephantiasis, surgical procedure.
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- Braun-Falco`s Dermatologie, Venerologie und Allergologie, 7. Auflage