LYMPHOGRANULOMA VENEREUM

By Gary M. White, MD

Lymphogranuloma venereum Courtesy Michael O Murphy, MD


Lymphogranuloma venereum is an STD caused by Chlamydia trachomatous. A mild penile ulcer followed by lymphadenopathy is typical.

Clinical

After a 3-30 day incubation period, a papulovesicle appears and progresses to a small and often unnoticed erosion in LGV. 1-2 weeks later, firm lymphadenopathy which may suppurate occurs. The classic groove sign is created by enlarged inguinal and femoral nodes separated by Poupart's ligament. LV may present as proctitis with anorectal discharge, rectal and/or abdominal pain, bloody stools, tenesmus, ulcer and/or itch.

Diagnosis

Diagnosis is made by the appropriate history and clinical findings plus a four fold or greater rise in the LGV complement fixation test.

Differential Diagnosis

See the penile ulcer.

Treatment

The appropriate public health guidelines should be followed. In the past, the following antibiotics may be given for 3 weeks: tetracycline 500 mg QID, doxycycline 100 mg. BID, minocycline 100 mg BID, sulfisoxazole 500 mg PO QID or erythromycin 500 mg QID. Fluctuant buboes may be aspirated.

Additional Pictures

Lymphogranuloma venereum Lymphogranuloma venereum

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