Lymphogranuloma Venereum: An Aggressive Form of Chlamydia

Among STDs, chlamydia is known as one of the most prevalent diseases along with syphilis and gonorrhea. A bacterial infection, this sexual disease is caused by Chlamydia trachomatis. As with HPV viruses, there are different strains of Chlamydia. The first main group is known to infect the urinary and genital areas while the other set attacks the lymphatic system.

One aggressive strain of Chlamydia is Lymphogranuloma venereum (LGV). Damaging the lymphatic system that is vital to a person’s immune system, this type of Chlamydia is more rare but nastier since the infection is more invasive and can damage the body’s tissue. If left untreated, LGV can result in serious health conditions. If Chlamydia often has no symptoms and often goes unnoticeable, LGV’s symptoms are painful and conspicuous. LGV is a result of 3 particular strains of Chlamydia trachomatis, which are serotypes L1, L2 and L3. This disease is not much found in big cities, but is endemic in some parts of India, Africa, Southeast Asia, South America and the Caribbean. Cases of LGV are more common in men compared to women.

Transmission of LGV

The transmission of LGV almost always happens because of sexual contact. The entry point for the bacteria is through a moist mucosal surface or skin-to-skin contact such as the rectum or the vagina. However, the bacteria can also be transferred by making contact with an infected person’s mouth, penis, or anus. What is more, the transmission of this disease is also enabled by using the same gloves, sex toys, and condoms between multiple partners. Also similar to all sexual infections, any kinds of sex (oral, anal or vaginal) with no condoms can spread LGV.

LGV infections happen in 3 stages and are characterized by small skin lesions and may be followed by the swelling of lymph nodes in the groin or pelvic areas. One severe health problem that can arise if LGV is not treated is the blockage of lymph flow.

Stage 1: The incubation period of LGV varies between 3 days to 3 weeks. The first telling sign is the appearance of a small sore around the mouth, penis, vagina or anus (wherever the bacteria gets in).

Stage 2: The second stage presents different symptoms in men and women. In men, it usually occurs 2 to 4 weeks later and is signified by the swelling of inguinal lymph nodes (can be on one side or both) and the forming of fluctuant masses that can later be inflamed. On the other hand, women usually experience backache or pelvic pain. First lesions normally appear on the cervix or upper vagina. Lymphadenopathy and inflammation take place in the perirectal or pelvic areas.

Stage 3: The final stage of LGV that develops after years of untreated infections. Complications may appear in the form of hemorrhoid-like masses and the swelling or genitals. More serious health problems revolve around internal organ damages, scarrings and abnormal growths that need to be removed by surgery. If a person engages in receptive anal sex, it is not impossible for grave proctitis with bloody rectal discharge to occur.

Besides the symptoms mentioned in the 3 stages above, people may experience other symptoms in between those 3 stages that revolve around:

  • Redness
  • Throbbing sensations (on the lining of the rectum, vagina, penis glans, urethra, or inside the mouth)
  • Extreme urgency to pee or defecate
  • Burning and painful sensations during defecating and peeing
  • Bloody discharge from genitals or bloody stool
  • Ulcers in the anus

How LGV is diagnosed

Diagnosing LGV can be done through taking a chlamydia test since it can also detect LGV. However, if the test results come back negative for chlamydia but a person has swollen glands, it would be wisest to get specifically tested for LGV. In general, a person can be suspected for LGV if they have genital ulcers, swollen inguinal lymph nodes, proctitis, or buboes. The diagnosis for LGV can be done with checking urine samples, taking swabs from infected areas, antibody detection and in some cases nucleic acid amplification testing (NAAT) if necessary.

It is imperative that a person be completely honest about which parts of the body are involved while having sex. This is especially helpful because LGV is on the rise among men who have sex with men. If the healthcare professional is not informed about important details, swabs may not be done on suspected areas. If you have multiple sex partners, do get tested once every 6 months.

Treatment for LGV

As with Chlamydia, treatment for LGV involves the use of antibiotics. For 21 days, the infected person will have to consume doxycycline. Some types of antibiotics will work against LGV, but there is very little connection between doxycycline and HIV drugs. You may start to feel better and more relieved after one or two weeks of antibiotics, but this ultimately depends on the severity of the infection.

After taking the prescribed antibiotics and the bacterias are eliminated, this does not automatically mean that the buboes, swelling or damaged tissues will go away on their own. Buboes and sinus tracts may sometimes be removed by surgery. It is important to note that people with LGV or other sexual infections should not be engaging in any kinds of sex until follow-up tests state that infections have cleared.

Preventing LGV

Similar to preventing other sexual infections, condoms should be worn during penetrative sex as well as oral sex. If you have multiple sex partners and use sex toys during sex, it is important to make sure that you have separate sex toys that are regularly cleaned for each partner or they should really use their own.

Every sexually active person is at risk of getting STDs. Get a restful night’s sleep by getting fully updated on your sexual health status by going for STD testing at a STD clinic. Shim Clinic is your partner when it comes to diagnosis and treatment of STDs/STIs and for general male sexual health. We also provide prevention methods such as HIV PEP, HIV PrEP and HPV vaccination (Gardasil-9).