Lymphogranuloma venereum (LGV)

Introduction. 

LGV is a sexually transmitted infection caused by certain Chlamydia trachomatis serotypes. It manifests itself as an initial small painless sore or ulcer that disappears within weeks. From there, the infection moves to the local lymph nodes, where swelling, ulceration and drainage of the node to the surface may occur.

Summary

• Cause: Chlamydia trachomatis (L serotypes)
• Microscopy: Gram-negative pleomorphic cells (elementary body & reticulate body)
• Transmission: STD
• Symptoms:
  • 1st stage: Small painless ulcer/lesion at infection site; fever, headache, myalgia
  • 2nd stage: painfully swollen lymph nodes in groin, may rupture/drain; fever, headache, chills, anorexia, myalgia, arthralgia
• Complications: proctitis, ulceration, genital elephantiasis
• Pathogenesis: Chlamidiae are intracellular pathogens. The infective form is the elementary body, which measures only 300 - 400 nm in size. LGV serotypes of C. trachomatis infect lymphocytes, making their way to the groin lymph nodes where they damage cells and provoke an inflammatory response causing granuloma formation. Symptoms are largely due to immune responses.
• Treatment: tetracycline for 3 weeks