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Lymphogranuloma venereum

3 May 2014, by HALIOUA B.

ACKNOWLEDGEMENTS

The text below has been provided by IUSTI (International Union against Sexually Transmitted Infections). This text was written with the help of the IUSTI, the EADV (European Association of Dermatology and Venereology) and its task force on Sexually Tansmitted Infections, the ISIDOG (International Society for Infectious Diseases in Obstetrics and Gynecology) and the UEMS-EBDV (European Union of Medical Specialists - European Board of Dermatovenereology).

The update is from 2017

You can download the pdf here

KEY POINTS

Lymphogranuloma venereum (LGV) is a sexually transmitted infection.

In Europe nearly all cases are seen in men who have sex with men (MSM).

It is passed from one person to another during sex.

It often causes no symptoms.

Treatment is simple.

If LGV is not treated it can cause serious long term health problems.

WHAT IS LYMPHOGRANULOMA VENEREUM? 

Lymphogranuloma venereum (LGV) is a sexually transmitted infection. It is caused by a bacterium called Chlamydia trachomatis L1- L3. (This is a different strain to the type that causes chlamydia infection).

HOW DO YOU GET LGV? 

— You can catch LGV when you have sex with someone who already has the infection. This can be by anal sex, fisting, sharing sex toys and, rarely, by oral sex. 

— Nearly all LGV in Europe is seen in men who have sex with men (MSM), especially if they are HIV positive. 

— Men having multiple partners and having sex in public venues such as saunas are at greatest risk of infection. 

— Even if you have had LGV before, you can still catch it again.

 WHAT ARE THE SYMPTOMS OF LGV? 

— LGV infection may cause no symptoms.

— The most common symptoms are pain in the rectum, a blood stained rectal discharge, constipation and the feeling of incomplete bowel emptying (tenesmus). 

— There may be a small painless pustule in the genital or rectal area which may then form an ulcer. This will heal in a few days without treatment. You may notice a discharge from your penis, or rectum. 

— 2 to 6 weeks later you may get swollen glands in your groin which can develop into an abscess and discharge pus. Swollen glands in your abdomen can cause lower abdominal pain or low back pain. 

— You may notice fever, chills, malaise, muscle and joint pain at the same time.

DO I NEED ANY TESTS? 

— If you are a man who has anal sex with other men or if you have symptoms suggestive of LGV you will need a sample from the genital area and / or rectum to make the diagnosis. 

— If you think you have been in contact with LGV, or other infections, or have symptoms that could be LGV you should visit your local sexual health or venereology/dermatology clinic. 

— The doctor or a specialist nurse will take a swab (sample) from any ulcer in the genital area and / or the rectum in men who have anal sex and send it to a laboratory where it will be tested for the bacteria that causes LGV. If you have swollen glands a sample of pus may be taken from these. 

— If you have LGV, you should also be tested for other sexually transmitted infections such as HIV, syphilis and gonorrhoea, as you can have more than one infection at the same time.

WHAT IS THE TREATMENT FOR LYMPHOGRANULOMA VENEREUM?

— It is important to receive treatment for LGV as quickly as possible, as the infection can cause complications and serious health problems if it is left untreated. 

— LGV is treated with a three week course of antibiotics, usually doxycycline or erythromycin.

SHOULD I HAVE SEX IF I HAVE LGV? 

You should avoid any sex, even with a condom, until after both you and your partner have finished all your treatment and your symptoms have gone. 

WHAT ARE THE POSSIBLE COMPLICATIONS OF LGV?

— LGV is unlikely to lead to any long-term problems if it is treated quickly. However, without treatment LGV can spread to other parts of your body and cause serious problems such as arthritis, chest and liver problems. Rarely causes inflammation of the heart or brain. 

— Eventually, without treatment, it can lead to inflammation in the rectal and genital areas with severe swelling and ulcers causing long term pain and bowel problems. 

DO I NEED TO TELL MY PARTNER? 

— If you do have LGV, it is essential that your current sexual partner, and any other sexual partner you have had over the last three months, is tested and treated. 

— This is to stop you getting the infection again, and also so your partners do not develop complications.

FURTHER HELP AND INFORMATION 

If you suspect that you have LGV or any other sexually transmitted infection, then see your family doctor or local sexual health or venereology/dermatology clinic. 

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