Sexually Transmitted Diseases (STDs In Men) (cont.)
Lymphogranuloma Venereum (LGV)
Lymphogranuloma Venereum is an uncommon genital or
anorectal (affecting the anus and/or rectum)
disease that is caused by a specific type of bacteria, Chlamydia trachomatis.
Men typically consult a doctor because of tender glands (lymph nodes) in the
groin. These patients sometimes report having recently had a genital ulcer that
subsequently resolved. Other patients, particularly women and homosexual men,
can have rectal or anal
inflammation, scarring, and narrowing (stricture), which
cause frequent small bowel movements
(diarrhea) and a sense of incomplete evacuation of the bowels. Other symptoms of
lymphogranuloma venereum include perianal pain (around the anal area) and
occasionally drainage from the perianal area or the glands in the groin. If an
ulcer appears, it is often gone by the time infected people seek care. Note that
another strain (type) of Chlamydia trachomatis, which can
be distinguished in specialized laboratories, causes inflammation of the
urethra.
First, or primary, infection is characterized by an
ulcer or irritation in the genital area and occurs 3 to 12 days following
infection; these early lesions heal on their own within a few days. Two to six
weeks later, the secondary stage of infection is characterized by spread of the infection to
lymph nodes, causing the tender and swollen lymph nodes in the groin. The
scarring that sometimes occurs following lymphogranuloma venereum arises if the infection is not
treated adequately in its early stages.
How is lymphogranuloma venereum diagnosed and treated?
The diagnosis of lymphogranuloma venereum is suspected in a person with typical symptoms and in
whom other diagnoses, such as chancroid, herpes, and syphilis have been
excluded. The diagnosis in such a patient is usually made by a blood test that
detects specific antibodies to Chlamydia, which are produced as part of the
body's immunologic (defensive) response to that organism.
Once lymphogranuloma venereum is diagnosed, it is
usually treated with doxycycline 100 mg twice
per day by mouth for 21 days. If this is not an option, for example, because of
intolerance to the drug, erythromycin base 500 mg four times per day by mouth
for 21 days can be given as an alternative.
What should a person do if exposed to someone with lymphogranuloma
venereum?
A person who has been sexually exposed to a person with lymphogranuloma
venereum should be
examined for signs or symptoms of lymphogranuloma venereum, as well as for chlamydial infection of
the urethra, since the two strains of Chlamydia trachomatis can co- exist in an
infected person. If the exposure occurred within 30 days of the onset of their
partner's symptoms of lymphogranuloma venereum, the exposed person should be treated.
Next: Syphilis »
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