Lymphogranuloma venereum is significantly more common in men than in women. Men are more probably to present with inguinal lymphadenopathy in the second stage of the illness.
Lymphogranuloma venereum (LGV) is a sexually transmitted illness that primarily infects the lymphatics. Lymphogranuloma venereum is reason by serovars of Chlamydia trachomatis. The bacterium is spread through sexual contact. It is rare in industrialised countries, but is endemic in parts of Africa, Asia, South America, and the Caribbean. It gains entrance through breaks in the skin, or it can cross the epithelial cell layer of mucous membranes. The organism travels from the site of inoculation down the lymphatic channels to multiply within mononuclear phagocytes of the lymph nodes it passes.
The primary symptom may be a small, painless pimple or lesion occurring on the penis or vagina. It is frequently unnoticed. The infection then spreads to the lymph nodes in the groin area and from there to the surrounding tissue. Complications may comprise inflamed and swollen lymph glands which may drain and bleed. The incubation period ranges from 3 to 12 days. The primary lesion is a 5- to 8-mm, soft, red, painless erosion or ulcer. The ulcer heals spontaneously in a few days. The secondary stage begins 2 to 6 weeks later and is characterized by the appearance of tender, inguinal adenopathy, which develops with over-riding erythema and edema.
The lymph nodes coalesce, may fluctuate, and drain spontaneously. Associated fever, chills, and malaise can be severe. Lymphogranuloma venereum can be cured by proper antibiotic therapy. Common antibiotic treatments include: tetracycline, doxycycline (all tetracyclines, including doxycycline, are contraindicated during pregnancy and in children due to effects on bone development and tooth discoloration), and erythromycin.
Aspiration of fluctuant buboes may prevent spontaneous rupture and reduce morbidity. Symptomatic treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) may be beneficial. Lymphedema in later stages may not resolve despite elimination of the organism. Fluctuant buboes may be aspirated or incised if necessary for symptomatic relief, but most patients respond quickly to antibiotics. Buboes and fistulas may require surgery, but rectal strictures can usually be dilated. Prevention is better than cure. The accurate use of condoms, either the men or women type, greatly decreases the risk of getting a sexually-transmitted disease.
