Lymphogranuloma venerum

Lymphogranuloma venerum is a tropical sexually transmitted disease caused by Chlamydia trachomatis (L1,L2,L3).

It is endemic in Africa, India, SE Asia, South America and the Caribbean, with men affected more commonly than women, principally between the age 20 to 30 years.

There are three stages to the disease:

• an asymptomatic ulcer which resolves rapidly
• an inguinal syndrome, between 1 week and 6 months later, with adenopathy (lymph nodes are painful) and bubo development. There is often systemic illness and malaise
• regional abscess or fistula, resulting in regional strictures, e.g. rectal strictures

Diagnosis is by serology and intradermal skin test with LGV antigen - Frei's test.

The condition spontaneously remits, but can be treated with tetracyclines or erythromycin. Patients with LGV may also harbour other sexually transmitted disease including syphilis.