What is LGV?

Lymphogranuloma venereum (LGV) is a sexually transmitted infection caused by specific, more invasive strains of Chlamydia trachomatis (serovars L1, L2, or L3). It is different from the more common urethral or cervical chlamydia infection.

LGV primarily infects the lymphatic system, leading to characteristic symptoms and potentially severe complications if not treated correctly.

The Stages and Symptoms of LGV

LGV infection typically occurs in three stages:

Stage 1: Primary Lesion

A small, painless ulcer, papule, or sore appears at the site of infection (e.g., penis, vagina, rectum) 3 to 30 days after exposure. This often goes unnoticed and heals quickly.

Stage 2: Lymphatic Spread

This occurs 2 to 6 weeks later. Bacteria spread to the lymph nodes, most commonly in the groin area. This causes them to become swollen, matted together, and painful. These swollen nodes are called 'buboes'. They can rupture and drain pus.

Stage 3: Late-stage Complications

If left untreated, LGV can cause chronic inflammation, leading to scarring, fistulas, and strictures in the genital and rectal areas. This can cause severe issues like genital elephantiasis (swelling) or rectal blockage.

Diagnosis and Treatment in Nepal

Diagnosis can be challenging as the initial symptoms are mild. At STD Nepal, we can use specific nucleic acid amplification tests (NAATs) on swabs from ulcers or lymph node fluid to confirm an LGV diagnosis.

Treatment for LGV requires a longer course of antibiotics than common chlamydia. The recommended treatment is Doxycycline for 21 days. It is crucial to complete the entire course to fully eradicate the infection and prevent long-term complications.