Lymphogranuloma venereum or LGV is a rare type of sexually transmitted infection caused by bacteria. This infectious disease is restricted to tropical areas of the world initially but outbreaks are reported now in the USA, the Europe and the UK. Men who have sex with men are largely infected with this type of bacteria. Unlike other infectious bacteria that causes sexually transmitted infection that affects only the superficial layers, this bacterium Chlamydia trachomatis infects the lymphatic system.
Causes :
LGV is a bacterial infection caused by Chlamydia trachomatis that affects the lymphatic system leading to infection. It is a long term infection or chronic (recurring) infection. Being HIV positive increases the risk of getting LGV infection. LGV is more prevalent in parts of South America and Central America.
Symptoms :
The symptoms may not start quickly after infection and it might take few days or even a month for the appearance of initial signs. Foul smelling liquid can get discharged from the lymph nodes of the groin area. The infected person can have problems in passing stool causing pain.
The skin may develop inflammation on the groin area. For women, the labia of the vaginal portion become red and swollen. For some men, the lymph nodes of the rectum get affected and become swollen leading to bloody discharge while passing stool. For the same reason, it can cause diarrhea and pain in the lower abdomen.
Who are at risk?
People with multiple sex partners and people who keep on changing partners for sex are at high risk of getting LGV. People who have receptive anal sex and oral sex are also at risk. Travelers who have sex with prostitutes in the endemic areas are at high risk. Men having sex with men are more prone to develop LGV than others.
Types :
- Primary LGV is quite common in men when compared with women. Initial symptoms can be seen within 3 days or sometimes 10 days of exposure. Painless lesions or papule is formed on the groin. It may cause painful urination when urethra is affected.
- Secondary type of LGV can occur within a month of getting infected. Medium sized tender nodes are formed in the lymph nodes of the groin expelling drainage. It can cause mild fever, nausea, vomiting and headache. In case of oral infection it can affect the mouth and throat causing redness and inflammation.
- Tertiary LGV can occur even after many years of infection. It can affect the rectum causing painful bowel movements, bloody discharge while passing stool and lower abdominal pain. It can cause loss of weight in severe cases.
Diagnosis :
Your doctor will conduct physical examination of the genitals and look for oozing of fluid from the rectum or anus. She may look for painful sores on the penis or swelling of vagina or labia in women. The lymph nodes of the groin become swollen. Tissue sample may be collected from the affected lymph nodes and tested in the lab. Blood test will be done for detecting the LGV bacteria.
Treatment :
Based on the symptoms, your doctor may prescribe antibiotics like doxycycline for 3 weeks. Azithromycin or erythromycin is also effective. For severe cases of lesions outbreak, the doctor may drain off the buboes to get immediate relief from pain. For removing buboes from the rectum, surgery may be done with strictures. The symptoms can improve within few days of taking antibiotics. To prevent any chance of spreading the infection the infected person should avoid having sex until it is completely cured.
Prognosis :
Full recovery is possible without complication if the infection is diagnosed in primary stage. With suitable doses of antibiotics recovery is fast. Secondary and tertiary stage patients may develop complications. There is possibility of getting re-infected even though the symptoms had improved with medications.
Prevention :
Avoid having sex with many partners. Use condom while having sex with unknown person. Refrain yourself from sex until the disease is cured completely. Restrict your sexual activity with one partner.