Infectious Disease Compendium

Lymphogranuloma Venereum

Diagnosis

Severs, malaise, and inguinal lymphadenopathy. It can cause proctitis, cervicitis, perimetritis, or salpingitis.

It starts as an ulcer, usually asymptomatic or a painless papule, pustule, or nodule.

Then causes painful adenopathy, usually unilateral, with lymphangitis.

Epidemiologic Risks

Sex in Africa, India, Southeast Asia, South America, and the Caribbean where it is endemic.

Increasing in the US as of 2005, especially the rectal form in gay men.

Microbiology

C. trachomatis serovars L1, L2, or L3

Hard to grow, use serology, DFA or PCR.

Empiric Therapy

Doxycycline 100 mg bid for 21 d is preferred.

OR erythromycin for 21 d

OR azithromycin 1 gm q week x 3 weeks

OR a quinolone.

Aspirate fluctuant buboes to prevent sinus tract formation.

Pearls

It can lead to genital elephantiasis, strictures, or fistulas.

(Review)

Last Update: 11/01/18.