Lymphogranuloma Venereum (LGV)

What is it?

LGV is short for Lymphogranuloma venereum. It is an infection of the urinary tract, throat and/or rectum. LGV is caused by 3 different types of the bacteria Chlamydia trachomatis (serovars L1, L2, L3). It is very common in Africa, Asia, South America and parts of the Caribbean, but cases have been reported in Toronto and other developed countries, especially among men who have sex with men (MSM).

How is it spread?

LGV is spread by anal, oral or vaginal sex without a condom. Transmission may also occur through condomless fisting or fingering of multiple partners at the same time or after each other. Sharing sex toys or sharing lubricant can also spread LGV.

What are the symptoms?

LGV has 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

  • Fever, chills, muscle pain, headaches, and fatigue

  • Painful lumps in the groin (lymph nodes), on one or both sides. If infection is in the throat, the person may have swollen lymph nodes in the neck

  • Drainage from lymph nodes in the groin

Stage 3

  • Occurs in 25% of patients

  • More common in people who receive anal sex

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

How is it diagnosed?

The most common means of detecting LGV is through a blood test and a swab of the infected site (urethral, rectal or vaginal).

How is it treated?

LGV is treated with antibiotics. It is important that you take all the pills as directed, even if the symptoms have disappeared.

What are the complications?

Untreated, LGV can cause chronic draining and scarring, elephantiasis (swollen legs) and/or scrotal and penile swelling. In others, is can also cause salpingitis (inflammation of the uterine tubes), infertility and scarring of the labia.

What about my sexual partner(s)?

All sexual partners within the past 2 months should be examined and treated. They should be treated even if their test result is negative. If your partners do not have symptoms, it is still possible they have LGV.

Follow-up

Individuals should follow up with their doctor a month after completed treatment.

Prevention

Using a condom every time you have sex will greatly reduce your chances of getting LGV and other sexually transmitted infections. Wash or cover sex toys in a new condom, but it is best to not share sex toys. If you are fisting someone, wear latex gloves and do not share lubricant.