Chapter 53 Sexually Transmitted Infections: Lymphogranuloma Venereum
INTRODUCTION
Description: Lymphogranuloma venereum (LVG) is a potentially destructive infection caused by one of a number of serotypes (L-1, L-2, L-3) of Chlamydia trachomatis. Although uncommon in the United States, this infection causes significant morbidity.
CLINICAL CHARACTERISTICS
Signs and Symptoms
• Painless vesicle that heals quickly leaving no scar, generally located on posterior aspect of vulva or vestibule
• Progressive adenopathy with bubo formation (groove sign—the “groove sign” is not specific to LGV; it may also be seen in other inflammatory processes such as acne inversa)
DIAGNOSTIC APPROACH
Workup and Evaluation
Laboratory: Complement fixation test (a titer of greater than 1 : 64 is highly suspicious for LGV). Approximately 20% of patients with LGV will have false-positive Venereal Disease Research Laboratory (VDRL) test results.
Special Tests: None indicated. (Biopsy of the lesions is not diagnostic because of the nonspecific damage present. Enlarged lymph nodes should not be biopsied or opened: chronic sinuses will result.)
