- Lymphogranuloma venereum (LGV) is a sexually transmitted systemic disease.
- C. trachomatis is the causative agent.
- There are three serotypes: LI, L2, and L3.
- LGV is rare in the United States (285 cases reported in 1993).
- LGV is endemic in Africa, India, parts of Southeast Asia, South America, and the Caribbean.
Primary lesion is caused by multiplication of organism at site of infection.
Papule, shallow ulcer.
Herpetiform lesion at site of inoculation (most common).
Incubation period is 3 to 21 days.
Most common site of lesion in women is the posterior wall, fourchette, or vulva.
Healing is spontaneous without scar.
- Second stage: Inguinal syndrome: Inguinal adenopathy is characteristic.
Begins 1 to 4 weeks after primary lesion.
Syndrome is the most frequent clinical sign of the disease.
Inguinal adenopathy is unilateral in 70% of cases.
Symptoms include painful, extensive adenitis (bubo), and suppuration may occur with numerous sinus tracts.
“Groove sign” signals femoral and inguinal node involvement (20%); most often seen in men.
Involvement of deep iliac and retroperitoneal lymph nodes in women may present as a pelvic mass.
- Third stage (anogenital syndrome).
Late: tissue destruction or scarring sinuses, abscesses, fistulas, strictures of perineum, elephantiasis