Lymphogranuloma Venereum

Question 1

Definition

Answer 1

Curable STI affecting the lymph vessels and nodes, caused by Chlamydia trachomatis.

Question 2

Transmission

Answer 2

• Unprotected anal, vaginal or oral sex
• The risk of catching LVG increased by high-risk such as group sex and fisting, as well as using recreational drugs. The risk may further be increased if HIV is positive.

Question 3

Signs

Answer 3

• First symptom = painless papule, pustule or ulcer on the penis, vulva, vagina or cervix.
• Presents in 3 stages:
  1 : small painless pustule which later forms an ulcer
  2 : painful inguinal lymphadenopathy; usually 10-30 days after the primary lesion
  3 : proctocolitis (most commonly seen in men who have sex with men); may mimic Crohn’s disease
  Pharyngeal symptoms are rare

Question 4

Diagnosis

Answer 4

Primary investigations:
- A swab is taken from the rectum, vagina, throat, or an ulcer (if present)
- NAATs : high sensitivity and specificity and, if positive for C.trachomatis, DNA may be tested for LGV-specific DNA

Question 5

Treatment

Answer 5

100mg oral doxycycline bd for 21 days