Table of ContentsView AllTable of ContentsCausesWho Might Get LGV?SymptomsDiagnosisTreatmentComplicationsHow to Reduce RiskOutlookHow Long It’s Contagious
Table of ContentsView All
View All
Table of Contents
Causes
Who Might Get LGV?
Symptoms
Diagnosis
Treatment
Complications
How to Reduce Risk
Outlook
How Long It’s Contagious
Early symptoms of LGV include painless bumps or ulcers that are sometimes mistaken forsyphilisorgenital herpes. Though easily treated withantibiotics, untreated LGV infections can lead to potentially severe complications, including rupturedlymph nodesoranal fistulas.
This article looks at the causes and symptoms of lymphogranuloma venereum, including how this uncommon STI is diagnosed and treated. It also describes the risk factors for LGV and what you can do to reduce your odds of infection.
Israel Sebastian / Getty Images
What Causes Lymphogranuloma Venereum (LGV)?
LGV differs from non-LGV chlamydia in that it primarily affects thelymphatic system(the group of organs, tissue, and fluids that helps the body fight infection).By contrast, chlamydia is mainly confined tomucosal tissuesat the site of the infection (including the genitals, rectum, and urinary tract).
LGV is transmitted (spread) through condomless anal, vaginal, and oral sex. The bacterium is found in body fluids such as semen, pre-ejaculate (“pre-cum”), vaginal fluids, and anal fluids.
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LGV is endemic (constantly present) in South and West Africa, India, Southeast Asia, and the Caribbean.It also affects countries in other areas withoccasional clusters and outbreaks. The last known LGV cluster in the United States occurred in Michigan and Illinois from 2015 to 2016.
LGV can affect anyone of any age, but sexually active people between 15 and 40 are at the greatest risk. People of all sexes may acquire LGV. But in Europe and North America, it is most often seen inmen who have sex with men (MSM)who havehuman immunodeficiency virus (HIV).
Research from the Centers for Disease Control and Prevention (CDC) suggests a rapid increase in LGV diagnoses among MSM who have HIV. All 38 cases of LGV confirmed in the 2015–2016 cluster were among HIV-positive MSM.
LGV in Men Who Have Sex With MenFor reasons unknown, rectal LGV infections among men who have sex with men (MSM) are 15 times more common than genital LGV infections in MSM.
LGV in Men Who Have Sex With Men
For reasons unknown, rectal LGV infections among men who have sex with men (MSM) are 15 times more common than genital LGV infections in MSM.
Causes and Risk Factors of STIs
LGV Symptoms
LGV occurs in three distinct stages as the bacterium progressively injures and, in some cases, permanently damages lymph nodes.
Primary Stage
During the primary infection, small, painless lesions will develop on the skin at the site of the exposure. The lesions may appear aspapules(bumps),pustules(pimple-like blisters), or shallowulcers.
Because the lesions are painless and short-lived, they may go entirely unnoticed, particularly if they occur in the mouth, vagina, or anus. Most primary LGV lesions clear within a few days.
Asymptomatic LGVSome early cases of LGV areasymptomatic(meaning without symptoms) and may only cause symptoms when the disease is advanced. Some studies suggest that 1 n 4 MSM with LGV are asymptomatic.
Asymptomatic LGV
Some early cases of LGV areasymptomatic(meaning without symptoms) and may only cause symptoms when the disease is advanced. Some studies suggest that 1 n 4 MSM with LGV are asymptomatic.
Everyone Should Know About Asymptomatic STIs
Secondary Stage
Secondary LGV typically causes painful, swollen lymph glands, also known asbuboes, in the groin area (inguinal lymphadenopathyorfemoral lymphadenopathy). One or both sides of the body may be affected. In some cases, the buboes will cause large, visible lumps under the skin.
If LGV infection occurs in the mouth or throat, there may be swelling of the lymph nodes of the neck (cervical lymphadenopathy).
Other symptoms may include:
Late Stage
The late stage, also known as late sequelae, can develop if LGV is left untreated. Prolonged LGV infection can causefibrosis(the scarring and thickening of tissues),adhesions(the sticking together of tissues), andnecrosis(tissue death) in both the lymph nodes and surrounding tissues.
This can lead to late-stage complications like:
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How Is LGV Diagnosed?
Differential Diagnosis
To help confirm the diagnosis, additional tests may be performed to exclude diseases with similar symptoms, such as:
Partner Notification
How Chlamydia Is Diagnosed
How Is LGV Treated?
LGV is curable at any stage of infection with antibiotics. Ideally, treatment should be administered at the earliest stage of infection to avoid complications.
Doxycycline is the preferred option because it has a cure rate of over 98.5%.
Whichever antibiotic is used, it is important to take it as prescribed and to completion. Skipping doses or stopping treatment early increases the risk of antibiotic resistance, making the infection harder to treat if it returns.
LGV Complications
Some people experience rare but serious complications of LGV. Some of these are caused whenChlamydia trachomatisdisseminates (spreads through the bloodstream) and affects distant organs. Others are inflammatory reactions to the infection or severe forms of late-stage symptoms.
Serious complications include:
How to Reduce Your Risk of LGV
You can reduce the odds of getting LGV in the same ways as with chlamydia, gonorrhea, and other STIs. It all starts withpracticing safer sex.
This includes:
8 At-Home STD Tests
What’s the Outlook for Someone With LGV?
The prognosis (outlook) of LPV is generally good if you get treated in a timely manner. The general rule of thumb is the earlier, the better.
Timing can be complicated if you are initially asymptomatic, as certain complications, such as ruptured buboes, can develop quite early and cause permanent scarring.At other times, LGV may be mistaken for other conditions and left untreated until potentially serious (and irreversible) complications like infertility occur.
This is why it is important to keep on top ofrecommended STI screeningsif you are at an increased risk of STIs. This includes sexually active MSM and females under 25. These groups of people are advised to undergo annual chlamydia screening.
How Long Is LGV Contagious?
LGV is considered contagious until the infection is fully cleared with antibiotics. The same applies to asymptomatic people who still haveChlamydia trachomatisin their semen, vaginal secretions, and anal secretions.
Despite the high cure rate with antibiotics like doxycycline, the CDC recommends follow-up testing three months after the completion of treatment just to be sure that you are in the clear or have not been reinfected.
LGV ReinfectionEven if you’ve been cured of LGV, you can get it again. This is why it’s important to maintain safer sex practices after treatment is complete.According to the American Sexual Health Association, around 1 in 5 people treated for chlamydia in the United States will be reinfected within the first few months.
LGV Reinfection
Even if you’ve been cured of LGV, you can get it again. This is why it’s important to maintain safer sex practices after treatment is complete.According to the American Sexual Health Association, around 1 in 5 people treated for chlamydia in the United States will be reinfected within the first few months.
Even if you’ve been cured of LGV, you can get it again. This is why it’s important to maintain safer sex practices after treatment is complete.
According to the American Sexual Health Association, around 1 in 5 people treated for chlamydia in the United States will be reinfected within the first few months.
Summary
LGV develops in stages, causing lesions at the site of the exposure before moving to lymph nodes, where they cause pain, swelling, and other symptoms. LGV can be diagnosed with a swab of lesions and successfully treated with a course of antibiotics. Consistent condom use and a reduction in the number of sex partners can substantially lower the risk of LGV.
17 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ceovic R, Guline SJ.Lymphogranuloma venereum: diagnostic and treatment challenges,Infect Drug Resist.2015;8:39–47. doi:10.2147/IDR.S57540Centers for Disease Control and Prevention.Chlamydia – CDC detailed fact sheet.Lesiak-Markowicz I, Schötta AM, Stockinger H, et al.Chlamydia trachomatis serovars in urogenital and ocular samples collected 2014–2017 from Austrian patients.Sci Rep.2019;9:18327. doi:10.1038/s41598-019-54886-5New Zealand Trust.Lymphogranuloma venereum.Chi KH, de Voux A, Morris M, et al.Detection of lymphogranuloma venereum–associatedChlamydia trachomatisL2 serovars in remnant rectal specimens collected from 7 US public health laboratories.Sex Transm Dis.2022;49(1):e26–e28. doi:10.1097/OLQ.0000000000001483de Voux A, Kent JB, Macomber K, et al.Notes from the field: cluster of lymphogranuloma venereum cases among men who have sex with men — Michigan, August 2015–April 2016.MMWR Morb Mortal Wkly Rep.2016;65:920–921, doi:10.15585/mmwr.mm6534a6Smolarczyk K, Mlynarczyk-Bonikowska B, Majewski S, Rudnicka E, Unemo M, Fiedor P.Lymphogranuloma venereum: an emerging problem in Poland.Postepy Dermatol Alergol.2022;39(3):587–593. doi:10.5114/ada.2020.101466Centers for Disease Control and Prevention.Sexually transmitted infections treatment guidelines, 2021: lymphogranuloma venereum (LGV).Saxon C, Hughes G, Ison C, UK LGV Case-Finding Group.Asymptomatic lymphogranuloma venereum in men who have sex with men, United Kingdom.Emerg Infect Dis.2016;22(1):112–116. doi:10.3201/eid2201.141867Ilyas S, Richmond D, Burns G, et al.Orolabial lymphogranuloma venereum, Michigan, USA.Emerg Infect Dis.2019;25(11):2112–2114. doi:10.3201/eid2511.190819O’Byrne PO, MacPherson P, Delaplante S, Metz G, Bourgault A.Approach to lymphogranuloma venereum.Can Fam Physician.2016;62(7):554–558.Centers for Disease Control and Prevention.Chlamydia trachomatis infection: 2022 case definition.Patel P, Prakash G, Planek MI, et al.A case of lymphogranuloma venereum and chlamydia associated myocarditis.J Am Coll Cardiol.2021;77(Supple_1):2676. doi:10.1016/S0735-1097(21)04031-6Caven LT, Carabeo RA.The role of infected epithelial cells in Chlamydia-associated fibrosis.Front Cell Infect Microbiol.2023;13:1208302. doi:10.3389/fcimb.2023.1208302New York Department of Health.Lymphogranuloma venereum.Centers for Disease Control and Prevention.Sexually transmitted infections treatment guidelines, 2021: screening recommendations and considerations referenced in treatment guidelines and original sources.American Sexual Health Association.Why do I need to retest after treatment?
17 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ceovic R, Guline SJ.Lymphogranuloma venereum: diagnostic and treatment challenges,Infect Drug Resist.2015;8:39–47. doi:10.2147/IDR.S57540Centers for Disease Control and Prevention.Chlamydia – CDC detailed fact sheet.Lesiak-Markowicz I, Schötta AM, Stockinger H, et al.Chlamydia trachomatis serovars in urogenital and ocular samples collected 2014–2017 from Austrian patients.Sci Rep.2019;9:18327. doi:10.1038/s41598-019-54886-5New Zealand Trust.Lymphogranuloma venereum.Chi KH, de Voux A, Morris M, et al.Detection of lymphogranuloma venereum–associatedChlamydia trachomatisL2 serovars in remnant rectal specimens collected from 7 US public health laboratories.Sex Transm Dis.2022;49(1):e26–e28. doi:10.1097/OLQ.0000000000001483de Voux A, Kent JB, Macomber K, et al.Notes from the field: cluster of lymphogranuloma venereum cases among men who have sex with men — Michigan, August 2015–April 2016.MMWR Morb Mortal Wkly Rep.2016;65:920–921, doi:10.15585/mmwr.mm6534a6Smolarczyk K, Mlynarczyk-Bonikowska B, Majewski S, Rudnicka E, Unemo M, Fiedor P.Lymphogranuloma venereum: an emerging problem in Poland.Postepy Dermatol Alergol.2022;39(3):587–593. doi:10.5114/ada.2020.101466Centers for Disease Control and Prevention.Sexually transmitted infections treatment guidelines, 2021: lymphogranuloma venereum (LGV).Saxon C, Hughes G, Ison C, UK LGV Case-Finding Group.Asymptomatic lymphogranuloma venereum in men who have sex with men, United Kingdom.Emerg Infect Dis.2016;22(1):112–116. doi:10.3201/eid2201.141867Ilyas S, Richmond D, Burns G, et al.Orolabial lymphogranuloma venereum, Michigan, USA.Emerg Infect Dis.2019;25(11):2112–2114. doi:10.3201/eid2511.190819O’Byrne PO, MacPherson P, Delaplante S, Metz G, Bourgault A.Approach to lymphogranuloma venereum.Can Fam Physician.2016;62(7):554–558.Centers for Disease Control and Prevention.Chlamydia trachomatis infection: 2022 case definition.Patel P, Prakash G, Planek MI, et al.A case of lymphogranuloma venereum and chlamydia associated myocarditis.J Am Coll Cardiol.2021;77(Supple_1):2676. doi:10.1016/S0735-1097(21)04031-6Caven LT, Carabeo RA.The role of infected epithelial cells in Chlamydia-associated fibrosis.Front Cell Infect Microbiol.2023;13:1208302. doi:10.3389/fcimb.2023.1208302New York Department of Health.Lymphogranuloma venereum.Centers for Disease Control and Prevention.Sexually transmitted infections treatment guidelines, 2021: screening recommendations and considerations referenced in treatment guidelines and original sources.American Sexual Health Association.Why do I need to retest after treatment?
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Ceovic R, Guline SJ.Lymphogranuloma venereum: diagnostic and treatment challenges,Infect Drug Resist.2015;8:39–47. doi:10.2147/IDR.S57540Centers for Disease Control and Prevention.Chlamydia – CDC detailed fact sheet.Lesiak-Markowicz I, Schötta AM, Stockinger H, et al.Chlamydia trachomatis serovars in urogenital and ocular samples collected 2014–2017 from Austrian patients.Sci Rep.2019;9:18327. doi:10.1038/s41598-019-54886-5New Zealand Trust.Lymphogranuloma venereum.Chi KH, de Voux A, Morris M, et al.Detection of lymphogranuloma venereum–associatedChlamydia trachomatisL2 serovars in remnant rectal specimens collected from 7 US public health laboratories.Sex Transm Dis.2022;49(1):e26–e28. doi:10.1097/OLQ.0000000000001483de Voux A, Kent JB, Macomber K, et al.Notes from the field: cluster of lymphogranuloma venereum cases among men who have sex with men — Michigan, August 2015–April 2016.MMWR Morb Mortal Wkly Rep.2016;65:920–921, doi:10.15585/mmwr.mm6534a6Smolarczyk K, Mlynarczyk-Bonikowska B, Majewski S, Rudnicka E, Unemo M, Fiedor P.Lymphogranuloma venereum: an emerging problem in Poland.Postepy Dermatol Alergol.2022;39(3):587–593. doi:10.5114/ada.2020.101466Centers for Disease Control and Prevention.Sexually transmitted infections treatment guidelines, 2021: lymphogranuloma venereum (LGV).Saxon C, Hughes G, Ison C, UK LGV Case-Finding Group.Asymptomatic lymphogranuloma venereum in men who have sex with men, United Kingdom.Emerg Infect Dis.2016;22(1):112–116. doi:10.3201/eid2201.141867Ilyas S, Richmond D, Burns G, et al.Orolabial lymphogranuloma venereum, Michigan, USA.Emerg Infect Dis.2019;25(11):2112–2114. doi:10.3201/eid2511.190819O’Byrne PO, MacPherson P, Delaplante S, Metz G, Bourgault A.Approach to lymphogranuloma venereum.Can Fam Physician.2016;62(7):554–558.Centers for Disease Control and Prevention.Chlamydia trachomatis infection: 2022 case definition.Patel P, Prakash G, Planek MI, et al.A case of lymphogranuloma venereum and chlamydia associated myocarditis.J Am Coll Cardiol.2021;77(Supple_1):2676. doi:10.1016/S0735-1097(21)04031-6Caven LT, Carabeo RA.The role of infected epithelial cells in Chlamydia-associated fibrosis.Front Cell Infect Microbiol.2023;13:1208302. doi:10.3389/fcimb.2023.1208302New York Department of Health.Lymphogranuloma venereum.Centers for Disease Control and Prevention.Sexually transmitted infections treatment guidelines, 2021: screening recommendations and considerations referenced in treatment guidelines and original sources.American Sexual Health Association.Why do I need to retest after treatment?
Ceovic R, Guline SJ.Lymphogranuloma venereum: diagnostic and treatment challenges,Infect Drug Resist.2015;8:39–47. doi:10.2147/IDR.S57540
Centers for Disease Control and Prevention.Chlamydia – CDC detailed fact sheet.
Lesiak-Markowicz I, Schötta AM, Stockinger H, et al.Chlamydia trachomatis serovars in urogenital and ocular samples collected 2014–2017 from Austrian patients.Sci Rep.2019;9:18327. doi:10.1038/s41598-019-54886-5
New Zealand Trust.Lymphogranuloma venereum.
Chi KH, de Voux A, Morris M, et al.Detection of lymphogranuloma venereum–associatedChlamydia trachomatisL2 serovars in remnant rectal specimens collected from 7 US public health laboratories.Sex Transm Dis.2022;49(1):e26–e28. doi:10.1097/OLQ.0000000000001483
de Voux A, Kent JB, Macomber K, et al.Notes from the field: cluster of lymphogranuloma venereum cases among men who have sex with men — Michigan, August 2015–April 2016.MMWR Morb Mortal Wkly Rep.2016;65:920–921, doi:10.15585/mmwr.mm6534a6
Smolarczyk K, Mlynarczyk-Bonikowska B, Majewski S, Rudnicka E, Unemo M, Fiedor P.Lymphogranuloma venereum: an emerging problem in Poland.Postepy Dermatol Alergol.2022;39(3):587–593. doi:10.5114/ada.2020.101466
Centers for Disease Control and Prevention.Sexually transmitted infections treatment guidelines, 2021: lymphogranuloma venereum (LGV).
Saxon C, Hughes G, Ison C, UK LGV Case-Finding Group.Asymptomatic lymphogranuloma venereum in men who have sex with men, United Kingdom.Emerg Infect Dis.2016;22(1):112–116. doi:10.3201/eid2201.141867
Ilyas S, Richmond D, Burns G, et al.Orolabial lymphogranuloma venereum, Michigan, USA.Emerg Infect Dis.2019;25(11):2112–2114. doi:10.3201/eid2511.190819
O’Byrne PO, MacPherson P, Delaplante S, Metz G, Bourgault A.Approach to lymphogranuloma venereum.Can Fam Physician.2016;62(7):554–558.
Centers for Disease Control and Prevention.Chlamydia trachomatis infection: 2022 case definition.
Patel P, Prakash G, Planek MI, et al.A case of lymphogranuloma venereum and chlamydia associated myocarditis.J Am Coll Cardiol.2021;77(Supple_1):2676. doi:10.1016/S0735-1097(21)04031-6
Caven LT, Carabeo RA.The role of infected epithelial cells in Chlamydia-associated fibrosis.Front Cell Infect Microbiol.2023;13:1208302. doi:10.3389/fcimb.2023.1208302
New York Department of Health.Lymphogranuloma venereum.
Centers for Disease Control and Prevention.Sexually transmitted infections treatment guidelines, 2021: screening recommendations and considerations referenced in treatment guidelines and original sources.
American Sexual Health Association.Why do I need to retest after treatment?
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