eMedicine Specialties > Infectious Diseases > Sexually Transmitted Diseases

Lymphogranuloma Venereum (LGV): Follow-up

Author: Alexandre F Migala, DO, Staff Physician, Department of Emergency Medicine, Denton Regional Medical Center
Contributor Information and Disclosures

Updated: May 15, 2009

Follow-up

Further Outpatient Care

  • For patients who have had incision and drainage of buboes, appropriate outpatient follow-up care may be required to ensure complete healing and to prevent secondary infections.

Deterrence/Prevention

  • Patients, especially those traveling to endemic areas, should be counseled about safe-sex practices, including condom use. Advise the patient to refrain from intercourse with high-risk individuals.
  • Inform patients that recovery from infection does not confer immunity against future infection.

Complications

  • Bubo rupture may lead to fistulas and sinus tracts. This complication typically occurs during the first stage (primary LGV) of infection.
  • Proctocolitis may lead to fissures, fistulas, abscess, scarring, and strictures.

Prognosis

  • With prompt and appropriate antibiotic therapy, the prognosis is excellent and patients typically make a full recovery.
  • Patients must be informed that reinfection and relapses may occur.

Patient Education

Miscellaneous

Medicolegal Pitfalls

  • Failure to consider the diagnosis
  • Failure to screen for HIV, herpes simplex virus (HSV), and syphilis

Special Concerns

  • Genital elephantiasis is a medical condition that occurs primarily in tropical environments. Genital elephantiasis is primarily due to filariasis infection. A small number of cases develop secondary to bacterial sexually transmitted infections such as LGV and donovanosis, while other causes include tuberculosis, malignancies, and dermatologic conditions. Although rarely seen in developed countries, this must be considered in patients returning from endemic areas.
 


More on Lymphogranuloma Venereum (LGV)

Overview: Lymphogranuloma Venereum (LGV)
Differential Diagnoses & Workup: Lymphogranuloma Venereum (LGV)
Treatment & Medication: Lymphogranuloma Venereum (LGV)
Follow-up: Lymphogranuloma Venereum (LGV)
References
Further Reading
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References

  1. Schachter J. Confirming positive results of nucleic acid amplification tests (NAATs) for Chlamydia trachomatis: all NAATs are not created equal. J Clin Microbiol. 2005;43:1372-1373.

  2. CDC. Lymphogranuloma venereum among men who have sex with men--Netherlands, 2003-2004. MMWR Morb Mortal Wkly Rep. 2004;53:985-988. [Medline].

  3. Stary G, Stary A. Lymphogranuloma venereum outbreak in Europe. J Dtsch Dermatol Ges. Nov 2008;6(11):935-40. [Medline].

  4. Gomes JP, Nunes A, Florindo C, Ferreira MA, Santo I, Azevedo J, et al. Lymphogranuloma venereum in Portugal: unusual events and new variants during 2007. Sex Transm Dis. Feb 2009;36(2):88-91. [Medline].

  5. Sethi G, Allason-Jones E, Richens J, Annan NT, Hawkins D, Ekbote A, et al. Lymphogranuloma venereum presenting as genital ulceration and inguinal syndrome in men who have sex with men in London, United Kingdom. Sex Transm Infect. Dec 9 2008;[Medline].

  6. Robertson A, Azariah S, Bromhead C, Tabrizi S, Blackmore T. Case report: lymphogranuloma venereum in New Zealand. Sex Health. Dec 2008;5(4):369-70. [Medline].

  7. Cusini M, Boneschi V, Arancio L, Ramoni S, Venegoni L, Gaiani F, et al. Lymphogranuloma Venereum: the Italian experience. Sex Transm Infect. Nov 26 2008;[Medline].

  8. Ward H, Alexander S, Carder C, Dean G, French P, Ivens D, et al. The prevalence of Lymphogranuloma venereum (LGV) infection in men who have sex with men: results of a multi-centre case finding study. Sex Transm Infect. Feb 15 2009;[Medline].

  9. Tinmouth J, Gilmour MW, Kovacs C, Kropp R, Mitterni L, Rachlis A, et al. Is there a reservoir of sub-clinical lymphogranuloma venereum and non-LGV Chlamydia trachomatis infection in men who have sex with men?. Int J STD AIDS. Dec 2008;19(12):805-9. [Medline].

  10. de Vries HJ, van der Bij AK, Fennema JS, Smit C, de Wolf F, Prins M, et al. Lymphogranuloma venereum proctitis in men who have sex with men is associated with anal enema use and high-risk behavior. Sex Transm Dis. Feb 2008;35(2):203-8. [Medline].

  11. Albay DT, Mathisen GE. Head and neck manifestations of lymphogranuloma venereum. Ear Nose Throat J. Aug 2008;87(8):478-80. [Medline].

  12. Benson PAS, Hergenroeder AC. Bacterial Sexually Transmitted Infections in Gay, Lesbian, and Bisexual Adolescents: Medical and Public Health Perspectives. Seminars Ped Inf Dis. 2005;16:181-191. [Medline].

  13. Brown TJ, Yen-Moore A, Tyring SK. An overview of sexually transmitted diseases. Part I. J Am Acad Dermatol. Oct 1999;41(4):511-32. [Medline].

  14. Burckhardt F. What is the impact of change in diagnostic test method on surveillance data trends in Chlamydia trachomatis infection?. Sex Transm Infect. 2006;82:24-30.

  15. Czelusta A, Yen-Moore A, Van der Straten M, et al. An overview of sexually transmitted diseases. Part III. Sexually transmitted diseases in HIV-infected patients. J Am Acad Dermatol. Sep 2000;43(3):409-32; quiz 433-6. [Medline].

  16. Fenton KA, Imrie J. Increasing Rates of Sexually Transmitted Disease in Homosexual Men in Western Europe and the United States: Why?. Inf Dis Clin North Am. 2005;19:311-331.

  17. Gupta S, Ajith C, Kanwar AJ. Genital elephantiasis and sexually transmitted infections - revisited. Int J STD AIDS. 2006;17:157-165.

  18. Hawkes S, Hart G. The sexual health of travelers. Infect Dis Clin North Am. Jun 1998;12(2):413-30. [Medline].

  19. Jones, RB, Batteiger, BE. Introduction to Chlamydial Diseases. In: In Mandell, G. Principles and practice of infectious diseases. 5th ed. Churchill-Livingstone;2000: 1989-90.

  20. Levine, W, Schmid, G. Approach to sexually transmitted diseases and genital tract infections. In: Kelley, W. Textbook of internal medicine, 3d ed. 3rd ed. Lippincott-Raven;1997: 1602-4.

  21. McDonald LL, Stites PC, Buntin DM. Sexually transmitted diseases update. Dermatol Clin. Apr 1997;15(2):221-32. [Medline].

  22. Quirk M. LGV: not new disease, but newly detected. Lancet Inf Dis. 2006;6:195.

  23. Rosen T, Brown TJ. Genital ulcers. Evaluation and treatment. Dermatol Clin. Oct 1998;16(4):673-85, x. [Medline].

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Further Reading

Clinical guidelines

Lymphogranuloma venereum (LGV).
New York State Department of Health - State/Local Government Agency [U.S.]. 2007 Aug. 11 pages. NGC:005903

2006 national guideline for the management of lymphogranuloma venereum.
British Association for Sexual Health and HIV - Medical Specialty Society. 1999 Aug (revised 2006 May). 14 pages. NGC:006016

Lymphogranuloma venereum (LGV). In: Sexually transmitted infections: UK national screening and testing guidelines.
British Association for Sexual Health and HIV - Medical Specialty Society. 2006 Aug. 6 pages. NGC:006400

Related eMedicine topics

Lymphogranuloma Venereum (Emergency Medicine)

Lymphogranuloma Venereum (Dermatology)

Chlamydia

Dermatologic Diseases of the Male Genitalia: Nonmalignant

Perianal Granuloma

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Keywords

lymphogranuloma venereum, LVG, sexually transmitted disease, STD, sexually transmitted infection, STI, Chlamydia trachomatis, C trachomatis, venereal disease, VD, HIV, AIDS, herpes simplex virus, HSV, syphilis, inguinal lymphadenopathy, genital papule, genital pustule, proctocolitis, genital ulcer disease, rectal stenosis, perirectal fissures, lymphorrhoids, elephantiasis, rectal adenocarcinoma, genitoanorectal syndrome, bubo, buboes, esthiomene, saxophone penis

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Contributor Information and Disclosures

Author

Alexandre F Migala, DO, Staff Physician, Department of Emergency Medicine, Denton Regional Medical Center
Alexandre F Migala, DO is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Osteopathic Association, Association of Military Osteopathic Physicians and Surgeons, and Texas Medical Association
Disclosure: Nothing to disclose.

Medical Editor

Kenneth C Earhart, MD, Deputy Head, Disease Surveillance Program, United States Naval Medical Research Unit #3
Kenneth C Earhart, MD is a member of the following medical societies: American College of Physicians, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, and Undersea and Hyperbaric Medical Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Charles V Sanders, MD, Edgar Hull Professor and Chairman, Department of Internal Medicine, Professor of Microbiology, Immunology and Parasitology, Louisiana State University School of Medicine at New Orleans; Medical Director, Medicine Hospital Center, Charity Hospital and Medical Center of Louisiana at New Orleans; Consulting Staff, Ochsner Medical Center
Charles V Sanders, MD is a member of the following medical societies: Alliance for the Prudent Use of Antibiotics, Alpha Omega Alpha, American Association for the Advancement of Science, American Association of University Professors, American Clinical and Climatological Association, American College of Physician Executives, American College of Physicians, American Federation for Medical Research, American Foundation for AIDS Research, American Geriatrics Society, American Lung Association, American Medical Association, American Society for Microbiology, American Thoracic Society, American Venereal Disease Association, Association for Professionals in Infection Control and Epidemiology, Association of American Medical Colleges, Association of American Physicians, Association of Professors of Medicine, Infectious Disease Society for Obstetrics and Gynecology, Infectious Diseases Society of America, Louisiana State Medical Society, Orleans Parish Medical Society, Royal Society of Medicine, Sigma Xi, Society of General Internal Medicine, Southeastern Clinical Club, Southern Medical Association, Southern Society for Clinical Investigation, and Southwestern Association of Clinical Microbiology
Disclosure: Nothing to disclose.

CME Editor

Eleftherios Mylonakis, MD, Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital
Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD, Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital
Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

 
 
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