eMedicine Specialties > Emergency Medicine > Infectious Diseases

Lymphogranuloma Venereum: Follow-up

Author: Andrew C Bushnell, MD, FACEP, Department of Surgery, Division of Emergency Medicine, Assistant Professor, University of Vermont College of Medicine
Contributor Information and Disclosures

Updated: Aug 17, 2009

Follow-up

Deterrence/Prevention

  • Infection confers little or no protective immunity against future infection.
  • Sexual contacts should be referred for evaluation and possible treatment.
  • Encourage the practice of safe sex.

Complications

  • Primary lymphogranuloma venereum (LGV)
    • Bubonuli may rupture to form sinuses or fistulas. This may result in long-term complications, including fibrosis and deforming scars at the penile base.
    • In women, cervicitis, perimetritis, or salpingitis may occur.
  • Tertiary LGV - Complete bowel obstruction from rectal stricture
  • Other complications of LGV include arthritis, conjunctivitis, hepatomegaly and, rarely, pericarditis, pneumonia, and meningoencephalitis.

Prognosis

  • Generally, full recovery is expected with appropriate treatment.
  • Reinfection/relapse may occur.

Patient Education

For excellent patient education resources, visit eMedicine's Pregnancy and Reproduction Center and Sexually Transmitted Diseases Center. Also, see eMedicine's patient education articles Sexually Transmitted Diseases, Birth Control Overview, Birth Control FAQs, and Chlamydia.

Miscellaneous

Medicolegal Pitfalls

The diagnosis of LGV is frequently missed in women and homosexual men because the initial lesion may not be readily visible and the associated noninguinal lymphadenitis may not be identified readily. In heterosexual men, the diagnosis frequently is made with the occurrence of the painful inguinal syndrome.

Special Concerns

Recent outbreaks have occurred in the western world involving men who have sex with men (MSM). The association with other sexually transmitted diseases, including HIV, has been large probably due to a decline in safe sex practices, and may also be facilitated by LGV infection.

 


More on Lymphogranuloma Venereum

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

  1. Lee DM, Fairley CK, Owen L, Horvath L, Chen MY. Lymphogranuloma venereum becomes an established infection among men who have sex with men in Melbourne. Aust N Z J Public Health. Feb 2009;33(1):94. [Medline].

  2. Halse TA, Musser KA, Limberger RJ. A multiplexed real-time PCR assay for rapid detection of Chlamydia trachomatis and identification of serovar L-2, the major cause of Lymphogranuloma venereum in New York. Mol Cell Probes. Oct 2006;20(5):290-7. [Medline].

  3. [Guideline] Behavioral counseling to prevent sexually transmitted infections: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. Oct 7 2008;149(7):491-6, W95. [Medline].

  4. Bremer V, Meyer T, Marcus U, Hamouda O. Lymphogranuloma venereum emerging in men who have sex with men in Germany. Euro Surveill. Sep 2006;11(9):152-4. [Medline].

  5. CDC. Lymphogranuloma venereum among men who have sex with men--Netherlands, 2003-2004. MMWR Morb Mortal Wkly Rep. Oct 29 2004;53(42):985-8. [Medline].

  6. [Guideline] Centers for Disease Control and Prevention, Workowski KA, Berman SM. Sexually transmitted diseases treatment guidelines, 2006. MMWR Recomm Rep. Aug 4 2006;55(RR-11):1-94. [Medline].

  7. Fitzpatrick TB, Johnson RA, Polano MK, et al. Color Atlas and Synopsis of Clinical Dermatology. McGraw-Hill Inc; 1992:398-400.

  8. Gilleece Y, Sullivan A. Management of sexually transmitted infections in HIV positive individuals. Curr Opin Infect Dis. Feb 2005;18(1):43-7. [Medline].

  9. Herida M, de Barbeyrac B, Sednaoui P, Scieux C, Lemarchand N, Kreplak G. Rectal lymphogranuloma venereum surveillance in France 2004-2005. Euro Surveill. Sep 2006;11(9):155-6. [Medline].

  10. Jones R. Chlamydia trachomatis (trachoma, perinatal infections, lymphogranuloma venereum, and other genital infections). In: Mandell G, Bennett J and Dolin R, eds. Principles and Practice of Infectious Diseases. 4th ed. Churchhill-Livingston; 1995:1679-93.

  11. Kropp RY, Wong T. Emergence of lymphogranuloma venereum in Canada. CMAJ. Jun 21 2005;172(13):1674-6. [Medline].

  12. Mabey D, Peeling RW. Lymphogranuloma venereum. Sex Transm Infect. Apr 2002;78(2):90-2. [Medline].

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  14. Pointer J. Genital infections. In: Rosen P, Barkin R, Braen G, eds. Emergency Medicine Concepts and Clinical Practice. 3rd ed. Mosby-Year Book; 1992:1966.

  15. Ronald A, Alfa M. Chancroid, lymphogranuloma venereum, and granuloma inguinale. In: Gorbach S, Bartlett J, and Blacklow N, eds. Infectious Diseases. 2nd ed. Philadelphia, Pa: WB Saunders Co;1998:1012-3.

  16. Sparling P. Sexually transmitted disease. In: Wyngaarden J, Smith L, and Bennett J, eds. Cecil Textbook of Medicine. 19th ed. Philadelphia, Pa: WB Saunders Co; 1992:1759-61.

  17. Stamm W, Holmes K. Chlamydial infections. In: Wilson J, Braunwald E, Isselbacher K, eds. Harrison's Principles of Internal Medicine. 12th ed. New York, NY: McGraw-Hill Inc; 1991:767-8.

  18. Stark D, van Hal S, Hillman R, Harkness J, Marriott D. Lymphogranuloma venereum in Australia: anorectal Chlamydia trachomatis serovar L2b in men who have sex with men. J Clin Microbiol. Mar 2007;45(3):1029-31. [Medline].

  19. van de Laar MJ. The emergence of LGV in western Europe: what do we know, what can we do?. Euro Surveill. Sep 2006;11(9):146-8. [Medline].

  20. van de Laar MJ, Fenton KA, Ison C,. Update on the European lymphogranuloma venereum epidemic among men who have sex with men. Euro Surveill. 2005;10(6):E050602.1. [Medline].

  21. van de Laar MJ, Koedijk FD, Gotz HM, de Vries HJ. A slow epidemic of LGV in the Netherlands in 2004 and 2005. Euro Surveill. Sep 2006;11(9):150-2. [Medline].

  22. van Weel J. Rare sexually transmitted disease hits Europe. Lancet Infect Dis. Dec 2004;4(12):720. [Medline].

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  24. Ward H, Martin I, Macdonald N, Alexander S, Simms I, Fenton K. Lymphogranuloma venereum in the United kingdom. Clin Infect Dis. Jan 1 2007;44(1):26-32. [Medline].

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Further Reading

Clinical guidelines

New York State Department of Health. Lymphogranuloma venereum (LVG). New York (NY): New York State Department of Health; 2007 Aug. 11 p.

Clinical Effectiveness Group, British Association for Sexual Health and HIV (BASHH). National guideline for the management of lymphogranuloma venereum (LVG). London (UK): British Association for Sexual Health and HIV (BASHH); 2006. 14 p.

Herring A, Richens J, LGV Incident Group, Health Protection Agency. Lymphogranuloma venereum (LGV). In: Ross J, Ison C, Carder C, Lewis D, Mercey D, Young H. Sexually transmitted infections: UK national screening and testing guidelines. London (UK): British Association for Sexual Health and HIV (BASHH); 2006 Aug. p. 57-62.

U.S. Preventive Services Task Force. Behavioral counseling to prevent sexually transmitted infections: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2008 Oct 7;149(7):491-6, W95. 3

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Keywords

lymphogranuloma venereum, lymphopathia venerea, tropical bubo, climatic bubo, strumous bubo, poradenitis inguinales, Durand-Nicolas-Favre disease, lymphogranuloma inguinale, LGV, sexually transmitted disease, STD, Chlamydia trachomatis, C trachomatis

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Contributor Information and Disclosures

Author

Andrew C Bushnell, MD, FACEP, Department of Surgery, Division of Emergency Medicine, Assistant Professor, University of Vermont College of Medicine
Andrew C Bushnell, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Medical Editor

Eric M Kardon, MD, FACEP, Attending Emergency Physician, Georgia Emergency Medicine Specialists; Physician, Division of Emergency Medicine, Athens Regional Medical Center
Eric M Kardon, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Jeter (Jay) Pritchard Taylor III, MD, Compliance Officer, Attending Physician, Emergency Medicine Residency, Department of Emergency Medicine, Palmetto Health Richland, University of South Carolina; Medical Director, Department of Emergency Medicine, Palmetto Health Baptist
Jeter (Jay) Pritchard Taylor III, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Rick Kulkarni, MD, Medical Director, Assistant Professor of Surgery, Section of Emergency Medicine, Yale-New Haven Hospital
Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: WebMD Salary Employment

 
 
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