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Lymphogranuloma Venereum (LGV)

Lymphogranuloma venereum (LGV) is a sexually transmitted infection involving the lymph glands in the genital area. It is caused by a strain of Chlamydia bacteria.

LGV is rare in Canada and occurs more commonly in countries closer to the equator. However, it is becoming more common in men who have sex with men. LGV is treated with antibiotics.

Causes

LGV is passed during vaginal (frontal), oral or anal sex. LGV involves the lymphatic system, and usually causes inflammation of lymphatic vessels, as well as swelling and abscesses in lymph nodes near the site where the bacteria entered the body.

Symptoms

LGV can cause open sores in the genital area, headache, fever, fatigue, and swelling of the lymph nodes in the pelvic area. Occasionally, LGV can cause symptoms in the joints, lungs, liver, nervous system or eyes. In people who have anal sex, there may be mucous discharge and bleeding from the rectum.

Genital sores may show up between 3-30 days after infection. Buboes (swelling of the lymph glands in the groin) may show up between 2-6 wekks after infection but it can take up to several months. Buboes can break open and cause scarring.

Complications

If LGV is not treated, there may be extreme swelling of the genitals. 

In women, swelling of the lymph nodes in the pelvis may cause infertility. In both men and women there can be inflammation of the rectum (proctitis) leading to rectal strictures (closing off) or fistulae (openings).

Rarely, untreated LGV can lead to inflammation of the brain and liver.

Tests and Diagnosis

Testing and diagnosis of LGV is based on symptoms, an exam of any sores or swelling, and a sexual history. Lab tests are required to confirm a diagnosis.

Treatment

LGV is treated with antibiotics. Occasionally, buboes may need to be drained.

Treatment for Partners

If you have LGV, you will be asked about who you had sex with in the past two months. This is because LGV is a reportable infection. Anyone you have had sex with will need to be tested and treated. Partners are almost always given medication whether they have symptoms or not. If you have not had sex in the past two months, your last partner should be tested.

There are a few ways you can tell your partners about STI testing. Some people want to tell partners in person, others want to tell partners anonymously. You can talk to your health care provider about what ways might work best for you.

Avoid Re-infection or Prolonging Infection

It is important for you to not have any sex (including oral, vaginal (frontal) and anal sex) for seven days after starting your antibiotic treatment, and until your partners have finished taking all their medication. It is important to take all the pills as instructed by your health care provider.

If you or your sexual partners miss pills or have sex before all the medication is finished, the infection may not be cured and could be passed back to your partner or cause complications. If you do not complete the treatment or miss doses, talk with your health care provider who will help you to decide whether you or your partners would benefit from further treatment.

Resources

BC Centre for Disease Control – Lymphogranuloma Venereum

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