Highlights & Basics
- Primary manifestation of lymphogranuloma venereum infection is painless penile or vulvar inflammation and ulceration at the site of inoculation; often not noticed by the patient.
- Secondary stage typically occurs weeks after development of the primary lesion; presents as painful, unilateral, inguinal or femoral lymphadenopathy (often referred to as "inguinal syndrome").
- Proctocolitis has emerged as a more typical presentation in men who have sex with men (particularly those who are HIV-positive).
- Chronic inflammation can lead to scarring and fibrosis causing lymphedema of the genitals, or formation of strictures and fistulae if anorectal involvement.
- Identification of Chlamydia trachomatis from the swab of a genital ulcer or aspiration of a bubo is definitive diagnosis.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
Penile ulceration, a primary manifestation of lymphogranuloma venereum
Inguinal and femoral lymphadenopathy, a secondary manifestation of lymphogranuloma venereum
Chronic inflammation from inguinal buboes leading to scarring and fibrosis, a tertiary manifestation of lymphogranuloma venereum
Lymphedema of the genitals with abscess and fistula formation
Citations
de Vries HJC, de Barbeyrac B, de Vrieze NHN, et al. 2019 European guideline on the management of lymphogranuloma venereum. J Eur Acad Dermatol Venereol. 2019 Jun 26;33(10):1821-8.[Abstract][Full Text]
Centers for Disease Control and Prevention. Lymphogranuloma venereum among men who have sex with men - Netherlands, 2003-2004. MMWR Morb Mortal Wkly Rep. 2004 Oct 29;53(42):985-8.[Abstract][Full Text]
Van der Bij AK, Spaargaren J, Morre SA, et al. Diagnostic and clinical implications of anorectal lymphogranuloma venereum in men who have sex with men: a retrospective case-control study. Clin Infect Dis. 2006 Jan 15;42(2):186-94.[Abstract][Full Text]
Stamm WE. Lymphogranuloma venereum. In: Holmes KK, Sparling PF, Stamm WE, et al., eds. Sexually transmitted diseases. 4th ed. New York, NY: McGraw Hill; 2007:595-606.
Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep. 2021 Jul 23;70(4):1-187.[Abstract][Full Text]
Mabey D, Peeling RW. Lymphogranuloma venereum. Sex Transm Infect. 2002 Apr;78(2):90-2.[Abstract][Full Text]
Thorsteinsson SB. Lymphogranuloma venereum: review of clinical manifestations, epidemiology, diagnosis, and treatment. Scand J Infect Dis Suppl. 1982;32:127-31.[Abstract]
Annamuthodo H. Rectal lymphogranuloma venereum in Jamaica. Ann R Coll Surg Engl. 1961 Sep;29:141-59.[Abstract][Full Text]
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