Lymphogranuloma Venereum

LGV is an STD caused by Chlamydia trachomatis, presenting as acute-to-chronic genital lesions with regional lymphadenopathy. Synonyms: tropical bubo, climatic bubo, Durand-Nicolas-Favre disease, fourth venereal disease.

Common Symptoms

Dyschezia; papule; periostitis; progressive granulomatous ulcer necrosis; granuloma; abdominal pain; low fever; meningitis; peritonitis

Causes and Pathogenesis

Pathogens are C. trachomatis serovars L1/L2/L3 (L2 most common, most invasive). Humans are the only host; broken skin/mucosa is the portal. L-strains invade deeper than other serovars, causing severe systemic disease. Pathology: thrombosing lymphangitis/perilymphangitis; primary regional nodes enlarge with stellate necrosis → abscesses → coalescence → rupture → fistulas/sinus tracts; healing by fibrosis obstructing lymphatics and impairing blood supply, causing edema/sclerosis/ulcers. CMI aggravates tissue damage. CFT antibodies aid diagnosis; CMI/humoral responses limit but do not eradicate infection. Pathogenesis: chlamydiae enter via microtrauma, drain to regional nodes; early LGV is localized to 1-2 node groups; endothelial proliferation in lymphoid sinuses causes small stellate "satellite abscesses" filled with PMNs; periadenitis mats adjacent nodes together. Later abscesses rupture into fistulas/sinuses; fibrosis leads to chronic edema/elephantiasis; rectal involvement causes proctitis, inflammatory stricture, sticky discharge. Hematogenous dissemination may involve CNS; host immunity determines localization vs dissemination; delayed-type hypersensitivity and LGV-specific antibodies appear 1-2 weeks after infection.

Treatment

Drug therapy, supportive therapy

Preventive Measures

Follow treated patients until symptoms resolve (3-6 weeks; 8-week self-resolution reported).

Department to Visit

It is recommended to visit the STD department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.