Lymphogranuloma Venereum

What is LGV?

LGV is short for Lymphogranuloma Venereum.

It is an infection of the urinary tract, throat and/or rectum. The main culprits of LGV are three different kinds of Chlamydia, a STD/ STI (sexually transmitted infection)

However, the same bacteria that cause genital Chlamydia does not cause LGV.  It is very common in Africa, Asia, South America, especially among men who have sex with men (MSM).

How is it spread?

LGV is almost exclusively transmitted sexually. The bacteria enter through a moist mucosal surface – most commonly, the rectum or vagina, but infections in the penis or mouth are also possible. Like all sexually transmitted infections, anyone who has vaginal, anal and/or oral sex without using a condom can acquire LGV.

The activity with the highest risk of LGV transmission is unprotected anal intercourse. Fisting, sharing of sex toys and rectal douching can also lead to LGV transmission.

LGV can be spread even when the person with LGV has no symptoms.

Who is at risk?

Sexually active people may be at risk of getting LGV.

It is diagnosed much more often in men than women. LGV is being increasingly reported in among men who have sex with men (MSM).

What are the symptoms?

LGV presents in 3 stages:

Stage 1

Symptoms can occur between 3-30 days after infection

Small painless sore/ulcer may appear at the site of infection (in the rectum, penis, vagina or mouth)

Initial symptoms may go unnoticed if the sore is in a place that is not visible

Sore may heal and patients may be asymptomatic until the secondary stage

Stage 2

Symptoms can occur between 2-6 weeks after the primary sore heals

Inflamed and swollen lymph glands may appear in the groin, armpit or neck. Anal infection can cause painful ulcerations, discharge and bleeding. You may also have fever, chills, muscle pain, headaches, and fatigue

Stage 3

This often presents years after infection and occurs primarily in women and men who have sex with men

Symptoms include rectal pain or discomfort and rectal bleeding with or without rectal discharge, constipation or diarrhoea.     

How is it diagnosed?

Blood tests and swabs from the infected ulcers are used to test for LGV.

If there are swollen lymph glands or abscesses, fluid from these can be tested to make the diagnosis.

How is it treated?

Antibiotics are effective in treating LGV. Three weeks of treatment are needed to treat LGV properly. Painful swollen lymph nodes may need to be drained using a needle. Sometimes surgery is required in later stages of the disease.

How is it prevented?

The use of condoms during sex reduces the risk of LGV. It’s important to use a new condom with each sexual partner. Sex toys should be washed with soapy water between partners and protected with a condom during use.

People diagnosed with LGV, whether or not they have symptoms, should refrain from sex until they have finished their 21-day course of antibiotics, to prevent transmitting the infection to others. 

If you suspect that you have LGV or any other sexually transmitted infection (STI), seek testing from a sexual health clinic near you.

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