Lymphogranuloma Venereum Treatment & Management

  • Author: Pamela Arsove, MD, FACEP; Chief Editor: Burke A Cunha, MD   more...
 
Updated: Nov 19, 2010
 

Medical Care

The complete treatment of patients with LGV includes appropriate antimicrobial coverage and drainage of infected buboes.

  • The recommended medical treatment for LGV involves one of the following antibiotic regimens:
    • Doxycycline 100 mg PO bid for 21 d
    • Erythromycin base 500 mg PO qid for 21 d
  • Sex partners who have had contact with the patient within the past 30 days should be evaluated and treated if symptomatic. If no symptoms are present, they should be treated for exposure as follows:
    • Doxycycline 100 mg PO BID for 7 days
    • Azythromycin 1 gm PO as a single dose[19]
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Surgical Care

Needle aspiration or incision and drainage of involved inguinal nodes may be required for pain relief and prevention of ulcer formation. Some of the late complications of the third stage of LGV may require surgical repair.

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Consultations

Surgical consultation for lymphadenopathy is generally not required unless extensive buboes require further exploration. For tertiary disease, appropriate surgical consultation is indicated.

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Activity

No restrictions to physical activities are required; however, patients should abstain from sexual contact until the infection resolves completely.

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Contributor Information and Disclosures
Author

Pamela Arsove, MD, FACEP  Associate Residency Director, Department of Emergency Medicine, Hofstra Northshore Long Island Jewish School of Medicine; Attending Physician, Department of Emergency Medicine, Long Island Jewish Medical Center; Assistant Professor, Department of Emergency Medicine, Albert Einstein College of Medicine

Pamela Arsove, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Barbara Edwards, MD  Associate Physician, Division of Infectious Diseases, Department of Medicine, Long Island Jewish Medical Center; Assistant Professor, Department of Medicine, Albert Einstein College of Medicine of Yeshiva University

Barbara Edwards, MD is a member of the following medical societies: American College of Physicians, Infectious Diseases Society of America, and Society for Healthcare Epidemiology of America

Disclosure: Nothing to disclose.

Specialty Editor Board

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.

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

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: Baxter International and Johnson & Johnson Royalty Other

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.

References

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  7. Martin-Iguacel R, Llibre JM, Nielsen H, Heras E, Matas L, Lugo R, et al. Lymphogranuloma venereum proctocolitis: a silent endemic disease in men who have sex with men in industrialised countries. Eur J Clin Microbiol Infect Dis. August 2010;29:917-25. [Medline]. [Full Text].

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

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

  10. 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].

  11. 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].

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  14. 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].

  15. Acknowledgement: Maria Jose Borrego. ESSTI_ALERT: LGV Cases Reported inDenmark and Portugal. ESTTI Newsletter No. 5. UK: ESTTI/Health Protection Agency; June 2007. 1-2. [Full Text].

  16. 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].

  17. 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].

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  22. 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.

  23. 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.

 
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