Lymphograuloma Venereum (LGV)
October 2013
Definition
Lymphogranuloma Venereum (LGV) is a sexually transmitted infection (STI) caused by
an aggressive strain of the bacterium Chlamydia trachomatis.
Causes
LGV can be passed on through unprotected oral, vaginal or anal sex from a person who is
infected. It can also be transmitted through fisting, sharing sex toys and having a new or
multiple partners.
Signs and Symptoms
LGV has three stages of the infection:
Stage 1 can occur three to 30 days after the infection. You may notice a small painless sore at
the site of the infection (rectum, penis, vagina or mouth), or you may notice nothing, as the
sore can be hidden inside the rectum, vagina or throat. The sore will heal on its own and may
go unnoticed in up to 50% of people with the infection.
Stage 2 usually occurs two to six weeks after stage 1. You may notice fever, chills, headaches
and fatigue, along with painful swelling of the glands (lymph nodes) closest to the site of
infection. A pus-filled swelling called bubo may be noticed in the groin area. If the infection is in
the rectum, there may be blood, pus, pain or constipation. If the infection is in the vagina or
penis there may be discharge. If the infection is in the mouth or throat, buboes may be located
in the neck or armpits.
Stage 3 occurs without treatment and is more common in females than males. You may notice
extreme swelling of the genitals, and/or abscesses. There may also be scarring or tissue
damage leading to the narrowing of the rectum or vagina.
Diagnosis and Tests
The diagnosis of LGV is not simple, as the signs and symptoms are similar to other sexually
transmitted infections (STIs). The diagnosis is often based on the sexual history, clinical
findings and laboratory testing.
Depending on the stage of the infection, if a lesion is present, a doctor or nurse will collect a
swab from the site of the infection (rectal, vaginal, throat or penis). They may also examine the
inside of your anus, rectum and lower part of the large intestine (anoscopy, sigmoidoscopy,
proctoscopy) to assess for inflammation, swelling, bleeding or pus. If a bubo is present, a
sample of the fluid inside will be collected.
Complications
If the infection progresses to the third stage, tissue damage of the vagina, rectum or site of
infection can occur, as the bacteria can lead to scarring. As a result, surgery may be required
to repair the genital/rectal damage.
In rare cases, an untreated infection can cause damage to the spinal cord, brain and the
surrounding membranes (meningoencephalitis). Untreated LGV can even lead to death.
Treatment
LGV can be treated with 3 weeks of antibiotics. Follow-up should be ongoing until chlamydial
tests are negative and no clinical symptoms remain.
Prevention/Self-care Tips
It is easier to get or give HIV if you have untreated LGV because of the bleeding and sores.
You may also be at higher risk for getting other STIs. Because of rates of co-infection, testing
for HIV, syphilis, herpes, gonorrhea, hepatitis B and hepatitis C is recommended.
Here are a few important points to remember:
• Wash or cover sex toys in a new condom if sharing.
• If you think you are infected, avoid any sexual contact.
• Use condoms correctly every time you have sex to lower your chance of getting an STI.
Information for Sexual Partners
It is important to inform all of your sexual partners within the past 60 days, so that they can be
tested and treated, regardless of whether they have symptoms. If you have not had sex in the
past 2 months, then your last sexual partner should be tested and treated. Tell your partner(s)
that having no symptoms does not mean there is no infection.
If you do not want to tell your partner(s), a public health nurse can notify them for you. Your
name will be kept confidential
For more information
Call the AIDS and Sexual Health InfoLine at 416 392-2437
SAFER SEX
To reduce your risk of getting a sexually transmitted infection (STI),
Use a condom every time you have vaginal, anal or oral sex.