What is lymphogranuloma venereum (LGV)?
Lymphogranuloma venereum, or Nicolas-Favre disease (in French), is a sexually transmitted infection (STI) caused by chlamydia trachomatis bacteria. There are different types of chlamydia trachomatis, with the bulk of them only capable of causing a shallow infection of the skin. The more infectious types L1-L3 can cause genital ulcerations.
Symptoms of LGV
LGV is frequently divided into three stages.
After the incubation period, a small painless pimple appears and changes over several days into an open wound. Symptoms in this stage usually goes unnoticed because the wound heals on its own with treatment.
This stage begins about 2 – 4 weeks after the wound has healed. LGV progresses into the second stage of infection leading to swollen groin region lymph nodes which affects the immune system. These lymph nodes appears on the same side as the initial pimple and become swollen and painful. The area may appear red and the nodes may actually open up to the outside of the skin and drain a white pus. Other symptoms at this stage includes headaches, nausea/vomiting, fever, fatigue, and limb pains.
At this stage, if the condition is still left untreated, these open sores can become badly scarred leading to obstruction of the lymphatic vessels. This final stage can lead to elephantiasis (abnormal and excessive swelling of the genitals).
Symptoms of LGV in Men
In men, the initial LGV pimple may appear on the penile head, the shaft, the foreskin, or body of the penis. It may also appear at the entrance to the urethra. Other parts that can be affected include the scrotum, thighs, and the anus or rectum.
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The genital ulcer may at times be accompanied by pus or urethral discharge. In advanced stage when elephantiasis occurs, the penis or scrotum increases in volume. The man may have difficulty during bowel movements when the infection manifests at the anus and rectum region.
Symptoms of LGV in Women
LGV is primarily located in the vagina, on the labia majora or minora, or the peri-anal region. In very rare cases, LGV appear on the uterine cervix (entrance to the uterus found at the end of the vagina).
Women with LGV may notice genital lesions accompanied by a pus or vaginal discharge. In advanced stages of elephantiasis, women may notice increase in the volume of the genital labia. When the initial infection affects the anus and rectum, it may lead to difficulty with defecation.
It is difficult to diagnose LGV using only clinical examination. Diagnosis is harder in regions where LGV incidence is very low. Culturing the base of the ulcer or wound is only helpful in identifying the microbe responsible. If LGV is suspected, diagnosis may be confirmed dosing an anti-chlamydial antibody levels (this is a blood test specific to the microbe responsible for the infection).
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It about takes two weeks for the antibody levels to rise and be detected in the blood. Even after LGV has been treated and cured, these same antibodies may remain elevated in the blood for long periods.
Who is at risk of contracting LGV?
Having unprotected sex is the greatest risk of contracting LGV. Other risk factors include:
- Having more than one sexual partner
- Not knowing the STI status of a new partner before engaging in sexual intercourse
- Having one night stand with unknown sexual partner;
Can LGV be treated?
LGV can be treated with antibiotic doxycycline, taken orally for a period of 3 weeks. There are alternatives to doxycycline for those individuals allergic, intolerant or pregnant. Pregnant women should avoid doxycycline because it increase the risk for birth defects.
If the inguinal lymph nodes are swollen, your doctor may make an incision to drain the pus. Patients who are also infected with HIV/AIDS may be treated with the same medications, however, the duration of treatment may be extended if resolution of lesions and symptoms is not fast. Your doctor will determine which medication is best for you.
How to avoid contracting LGV
- Use a latex or polyurethane condom for new sexual partners
- Stick to only one partner who has undergone test and is free of sexually transmitted illnesses, and genital lesions.
Article source: cliniquelactuel.com
Image source: pinterest.com
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