What is Lymphogranuloma Venereum?

Lymphogranuloma venereum is a sexually transmitted disease caused by a bacterium called Chlamydia trachomatis. The disease has several other names, including Durand-Nicolas-Favre disease, tropical bubo, strumous bubo, climatic bubo, venereal lymphogranuloma, and poradenitis inguinales. Lymphogranuloma venereum is uncommon in the Unites States and Europe, but is more widespread in South America and tropical locations.

In general, women are more vulnerable to sexually transmitted diseases than men. In contrast, men are more likely than women to have lymphogranuloma venereum. As with other sexually transmitted diseases, people who have had several sexual partners are at a higher risk of being exposed to the disease-causing bacteria.

Most individuals begin experiencing lymphogranuloma venereum symptoms within a month of contact with an infected person. Common symptoms include the formation of ulcers in the vagina or on the penis, swelling of lymph nodes in the groin, and pain in the lower abdomen. If the infection is contracted via anal intercourse, additional symptoms may include swelling of rectal lymph nodes, blood and pus in stool, and pain during bowel movements.

Women may experience additional symptoms, one of which is swollen labia. In women the disease may also cause a fistula to develop between the anus and vagina. A fistula is an abnormal connection, and in this case means that a hole has developed between the vagina and anus and connects the two tracts. The development of a fistula may cause infection to worsen or spread as a result of feces draining through the vagina. Fistulas may also develop in the penis in men, or in the rectum or urethra in both sexes.

Diagnosis of the disease is made based on symptoms as well as the results or serological tests. These types of tests use a patient’s blood sample to check for antibodies that recognize the Chlamydia trachomatis bacteria. If such antibodies are present it indicates that the patient has come into contact with the bacteria. Sometimes the serological tests are not conclusive; in these cases patient samples are taken to try and grow the bacteria in a laboratory so that it can be identified.

Lymphogranuloma venereum treatment involves a course of antibiotics such as doxycycline, erythromycin, or tetracycline. Providing that the full course of antibiotics is taken, and any other doctor's recommendations are followed, this treatment will resolve most cases of the disease. If complications such as a fistula or a spreading infection are involved additional treatment is often required.

If treatment is not administered or is ineffective, complications such as infection of joints or organs may result. In very rare cases the infection may spread to the blood or brain, causing septicemia or meningitis, respectively. These complications require hospital treatment and intravenous antibiotics.