A Serious Chlamydia Variant Requiring Prompt Treatment
LGV is an aggressive form of chlamydia that can cause severe complications if untreated. It predominantly affects men who have sex with men and requires specific testing and extended treatment.
Lymphogranuloma Venereum (LGV) is caused by specific serovars (L1, L2, L3) of Chlamydia trachomatis. Unlike regular chlamydia, LGV is an invasive infection that affects the lymphatic system and can cause serious complications. Since 2003, outbreaks have occurred among men who have sex with men in Europe and North America, often associated with HIV co-infection. LGV requires longer antibiotic treatment than standard chlamydia.
LGV diagnosis requires a two-step process: first, testing for Chlamydia trachomatis using PCR (swab or urine), then specific LGV genotyping on positive samples. We take samples from all potentially exposed sites - rectal, urethral, and throat. If you have symptoms suggestive of LGV, inform us so we can request appropriate testing. Standard chlamydia tests don't distinguish LGV.
LGV requires 21 days of doxycycline (longer than standard chlamydia treatment). Alternative regimens include azithromycin or erythromycin. Treatment should start promptly once LGV is suspected, even before genotyping results. Sexual partners should be notified and tested. Follow-up testing confirms cure. Untreated LGV can cause permanent complications.
LGV is caused by specific aggressive strains of Chlamydia trachomatis that invade deeper tissues and the lymphatic system. Regular chlamydia affects mucosal surfaces. LGV requires 21 days of treatment versus 7 days for standard chlamydia, and can cause more serious complications if untreated.
Standard PCR tests will detect that you have Chlamydia trachomatis, but won't distinguish LGV strains. If you have symptoms suggestive of LGV (especially rectal symptoms), the laboratory can perform additional genotyping on positive samples to identify LGV. Tell us if you have concerning symptoms.
The current LGV epidemic predominantly affects MSM, particularly those with HIV, multiple partners, and those engaging in receptive anal sex. The reasons relate to sexual networks and transmission dynamics. LGV can affect anyone through any sexual contact, but risk is currently concentrated in this population.
You should avoid sexual contact until you've completed the full 21-day course of treatment AND your symptoms have fully resolved. A test of cure is recommended 3-4 weeks after completing treatment. Your partners should also be tested and treated before resuming sexual contact.
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