Last reviewed: 3 Feb 2021
Last updated: 01 Nov 2019
Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- inguinal lymphadenopathy
- non-specific symptoms of proctocolitis
- groove sign of Greenblatt
- genital elephantiasis, saxophone penis, esthiomene
Other diagnostic factors
- fever, malaise, arthralgias
- lower abdominal or lower back pain
- genital or anal ulcer
- non-specific symptoms of bacteraemic spread
- erythema nodosum
- anogenital sinus tracts, strictures, or fistulae
Risk factors
- other STDs
- risky sexual behaviour
- HIV-seropositivity
- age (20 to 40 years)
- unprotected intercourse in an area endemic for LGV
- male
Diagnostic investigations
1st investigations to order
- genital or lymph node specimens for nucleic acid amplification test (NAAT)
- serum for complement fixation
- serum for micro-immunofluorescence (MIF)
- swab via anoscopy for Gram staining
Investigations to consider
- STD testing
- fluid or swab for real-time polymerase chain reaction (RT-PCR)
- biopsy via proctosigmoidoscopy with histopathology
- CT of abdomen and pelvis
- MRI of abdomen and pelvis
- fluid or swab for culture
Treatment algorithm
Contributors
Authors
Attending Physician
Division of Hospital Medicine
MedStar Georgetown University Hospital
Washington
DC
Disclosures
BDL declares that he has no competing interests.
Dr Benjamin D. Lorenz would like to gratefully acknowledge Dr Mettassebia Kanno, a previous contributor to this topic.
Disclosures
MK declares that she has no competing interests.
Peer reviewers
Department of General Internal Medicine
Leiden University Medical Centre
Leiden
The Netherlands
Disclosures
CvN declares that he has no competing interests.
Chair
Department of Obstetrics and Gynecology
Virginia Commonwealth University
Richmond
VA
Disclosures
DC declares that he has no competing interests.
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