Lymphogranuloma venereum is a sexually transmitted disease that is caused by Chlamydia trachomatis and that causes painful, swollen lymph glands in the groin and sometimes infection of the rectum.
Lymphogranuloma venereum is caused by types of Chlamydia trachomatis other than those that usually cause infection of the urethra (urethritis) and cervix (cervicitis). The infection occurs mostly in tropical and subtropical areas and is rare in the United State. In Western Europe, this infection has become a common cause of rectal infection (proctitis) in homosexual men.
Symptoms begin 3 or more days after infection. A small, painless, fluid-filled blister develops, usually on the penis or in the vagina. Typically, the blister becomes a sore that quickly heals and is often unnoticed. Then, lymph nodes in the groin on one or both sides may swell and become tender. The enlarged, tender lymph nodes (called buboes) attach to the deeper tissues and the overlying skin, which becomes inflamed. If infection lasts a long time or recurs, lymphatic vessels (which drain fluids from tissues) may be blocked, causing genital tissues to swell. Rectal infection may cause scarring, which can narrow the rectum.
Lymphogranuloma venereum is suspected based on its characteristic symptoms. The diagnosis can be confirmed by a blood test that identifies antibodies against Chlamydia trachomatis.
If given early in the infection, doxycycline, erythromycin, or tetracycline, taken by mouth for 3 weeks, cures the infection, but swelling may persist if lymphatic vessels are irreversibly damaged.
Last full review/revision October 2008 by J. Allen McCutchan, MD, MSc