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Lymphogranuloma Venereum
Lymphogranuloma Venereum

Lymphogranuloma Venereum conditions, Symptoms and Treatment

Lymphogranuloma venereum(LGV) is a bacterial infection of the genital area caused by chlamydia trachomatis bacteria. LGV is a sexually transmitted disease that is commonly transmitted through anal, vaginal or oral sex. This STD has three stages, but getting treated early can prevent you from the health complications attached to it.

The first stage of this infection starts with blisters filled with fluid on your genitals. In the second stage, you might notice painful or swollen lymph nodes on your rectum, pelvis or rectum. If left untreated, LGV can cause health complications. It is usually treated with antibiotics, and if left for long without treatment, LGV can cause severe damage to your lymphatic system and increase your risks of getting other STDs.

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Who is at risk of getting LGV?

People who are between 15 and 40 years of age and are sexually active are at a higher risk of getting lymphogranuloma venereum. LGV is not gender specific and affects both women and men, but certain people, based on their sexual activity, are at a high risk. MSM (men who have sex with men) have been reported to be affected by this bacterial infection as compared to women. If you have other STDs that weaken the immune system, such as HIV, you are also at a higher risk of getting LGV.

How common is Lymphogranuloma venereum?

The highest incidence of LGV is found in subtropical and tropical regions. Lymphogranuloma venereum is generally in the UK, especially among heterosexual people, but more frequent in men who have sex with men. If you are a man who has sex with men, you can undergo regular testing and practise safe sex to reduce your risk of contracting this infection.

What is responsible for Lymphogranuloma venereum?

LGV is a bacterial infection caused by chlamydia trachomatis. There are different types of this bacteria, but the ones responsible for LGV are serovars L1, L2 and L3. Chlamydia trachomatis also causes some common STDs apart from LGV such as chlamydia which is caused by serovars D-K. Lymphogranuloma venereum infection is commonly transmitted through oral, anal or vaginal sex.

Symptoms of Lymphogranuloma venereum

If you have been recently exposed to Lymphogranuloma venereum, you may not notice symptoms immediately as it usually takes 3 – 12 days on average for symptoms to appear. The symptoms appear in 3 stages.

  • First stage:

    This is the earliest stage, and you usually notice fluid-filled blisters with a size of 1-6mm around the genitals (vagina and penis). They mostly aren’t painful and heal on their own within a short time. Sometimes, you may notice sores in your throat or mouth.

  • Second stage:

    This stage of symptoms occurs after 2 – 6 weeks from the first stage. The symptoms differ in men and women.

    • Symptoms in men include tender and swollen lymph nodes in the groin.
    • Symptoms in women include painful and swollen lymph nodes in the pelvis and close to the rectum.

You may notice the skin on the lymph node breaking down, and this causes a passageway that releases blood or pus drain onto the skin.

You may also notice:

  • Fatigue
  • Constipation
  • Abdominal pain
  • Anal pain
  • Back pain or pain in the pelvis for women
  • Fever and headache
  • Unexplained weight loss
  • Rectal itching, discharge or bleeding
  • Painful urination and pain while passing out poop
  • Inflammatioon of the anus and rectum
  • Feeling like you need to poop
  • Body aches
  • Third stage:

    This stage usually occurs after you have undergone treatment but weren’t properly treated. You will notice scars from the sores that have healed. Sometimes, you will have sinus tracts.

    Other Lymphogranuloma venereum symptoms are:

    • Anal fistulas
    • Swelling of the genitals
    • Narrowing of the rectum
    • Abscesses
    • Deformed genitals
    • Swollen genitals

How is this viral infection diagnosed?

During your visit, your healthcare professional will ask you questions regarding any symptoms you might be noticing pertaining to Lymphogranuloma venereum. Information regarding your sexual history will also be helpful. Afterwards, they will perform a physical examination. If LGV is suspected, the following tests might be carried out including:

  • Nucleic acid amplification test (NAAT) screens for the bacteria in the sample taken from your lymph node, rectum or groin.
  • Blood test screens for antibodies reacting to chlamydia trachomatis

Medical professionals tend to diagnose women with LGV in the later stages and men in the earlier stages of infection.

What treatment is available for LGV?

There are several antibiotic treatments available to combat this STD. Most healthcare practitioners will prescribe doxycycline as the first line of antibiotic treatment or azithromycin and erythromycin as alternative treatments. For doxycycline, you are recommended to take 100mg twice daily for 21 days. Your medical practitioner might also recommend a fine needle aspiration(FNA) or a needle biopsy if you have a lymph node filled with pus in your groin. This FNA option can help you relieve yourself of discomfort and pain.

What method can I use to reduce my risk of LGV?

The following steps can help you reduce your risk of contracting Lymphogranuloma venereum:

  • Use condoms, dental dams or other protection while having sexual intercourse
  • Get diagnosed if you notice symptoms of LGV and follow up with treatment.
  • Avoid engaging in unsafe sex and try to limit the number of sexual partners you have.
  • If you are diagnosed with LGV, kindly inform your partners so they can also get tested, including anyone you have been sexually involved with 60 days before your diagnosis.

What can I expect if my LGV test is positive?

If your test is positive for Lymphogranuloma venereum or you have a long-term infection, you may experience any of the following:

  • Infertility
  • Narrowing of the rectum
  • Anal fistulas
  • Reactive arthropathy (joint disease)
  • Enlargement of the genitals
  • Blockage of the lymph node passing through the lymphatic system

If LGV goes untreated for a long time, you may also experience pneumonia or hepatitis. If strictures or fistulas cause severe damage to your rectum or anum, surgery may be needed.

Living with LGV

If you have been diagnosed with Lymphogranuloma venereum in the early stage and have begun treatment, there is a high chance that you can fully recover from this condition. If you follow prescriptions and take your doxycycline medications daily for 21 days, there is a 98.5% chance that you will be cured of LGV. You may still have swellings if the lymph that carries fluid from your lymphatic vessels is damaged.

LGV-infected individuals may be at higher risk of other STIs, including:

  • HIV
  • Syphilis
  • Hepatitis B
  • Hepatitis C
  • Gonorrhoea

Your healthcare professional might ask that you get tested for these STIs so you can get treated if necessary.

How can I prevent transmitting LGV to your partner?

The best way to prevent spreading this infection to your partner is to abstain from sex until you have completed the treatment. Afterwards, you can practise the use of condoms to avoid reinfection in future. Regular testing of you and your partner can help you maintain good sexual health and general well-being.

Get tested today

Early detection of Lymphogranuloma venereum is vital to protecting yourself and your partner. If you feel you might have been exposed to LGV or are showing symptoms, reach out to us at STI Clinic UK right away for confidential testing, advice, and support.