Lymphogranuloma venereum is a sexually transmitted disease caused by Chlamydia trachomatis. It 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—see Chlamydial and Other Infections). The infection occurs mostly in tropical and subtropical areas and is rare in the United State. Recently, in Western Europe, rectal infections caused by these bacteria have become more common among men who have sex with 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. The skin over the affected lymph nodes may break down and discharge pus or blood onto the skin.
People may have a fever and feel generally unwell. Women often have a backache or pain in the pelvis (the lowest part of the torso).
If infection lasts a long time or recurs, lymphatic vessels (which drain fluids from tissues) may be blocked, causing genital tissues to swell and sores to form on the skin. 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 (which are antibiotics), taken by mouth for 3 weeks, cures the infection, but swelling may persist if lymphatic vessels are irreversibly damaged.
Doctors may use a needle or make an incision to drain buboes if they are causing discomfort.
Current sex partners should be examined and, if infected, treated.
Last full review/revision December 2014 by J. Allen McCutchan, MD, MSc