When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Lymphogranuloma venereum

Last reviewed: 13 Sep 2025
Last updated: 11 Mar 2025

Summary

Definition

History and exam

Key diagnostic factors

  • inguinal lymphadenopathy
  • nonspecific symptoms of proctocolitis
  • groove sign of Greenblatt
  • genital elephantiasis, saxophone penis, esthiomene
Full details

Other diagnostic factors

  • fever, malaise, arthralgias
  • lower abdominal or lower back pain
  • genital or anal ulcer
  • nonspecific symptoms of bacteremic spread
  • erythema nodosum
  • anogenital sinus tracts, strictures, or fistulae
Full details

Risk factors

  • other STIs
  • risky sexual behavior
  • HIV-seropositivity
  • age (20 to 40 years)
  • unprotected intercourse in an area endemic for LGV
  • male
Full details

Diagnostic investigations

1st investigations to order

  • genital or lymph node specimens for nucleic acid amplification testing (NAAT)
  • swab via anoscopy for Gram staining
  • fluid or swab for LGV-specific molecular testing
  • STI testing
Full details

Investigations to consider

  • endoscopy with histopathology
  • serum for complement fixation
  • serum for microimmunofluorescence (MIF)
  • CT of abdomen and pelvis
  • MRI of abdomen and pelvis
  • fluid or swab for culture
Full details

Emerging tests

  • fluid or swab for genovar typing

Treatment algorithm

INITIAL

asymptomatic adolescent and adult patients who have been exposed to lymphogranuloma venereum (LGV)

ACUTE

all stages of lymphogranuloma venereum (LGV)

Contributors

Authors

Benjamin D. Lorenz, MD

Assistant Professor

Division of Hospital Medicine

MedStar Georgetown University Hospital

Washington

DC

Disclosures

BDL declares that he has no competing interests.

Acknowledgements

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.

Revisores por pares

Cees van Nieuwkoop, MD

Department of General Internal Medicine

Leiden University Medical Centre

Leiden

The Netherlands

Divulgaciones

CvN declares that he has no competing interests.

David Chelmow, MD

Chair

Department of Obstetrics and Gynecology

Virginia Commonwealth University

Richmond

VA

Divulgaciones

DC declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referencias

Nuestros equipos internos de evidencia y editoriales colaboran con colaboradores expertos internacionales y revisores pares para garantizar que brindemos acceso a la información más clínicamente relevante posible.

Artículos principales

de Vries HJC, de Barbeyrac B, de Vrieze NHN, et al. 2019 European guideline on the management of lymphogranuloma venereum. J Eur Acad Dermatol Venereol. 2019 Jun 26;33(10):1821-8.Texto completo  Resumen

Centers for Disease Control and Prevention. Lymphogranuloma venereum among men who have sex with men - Netherlands, 2003-2004. MMWR Morb Mortal Wkly Rep. 2004 Oct 29;53(42):985-8.Texto completo  Resumen

Van der Bij AK, Spaargaren J, Morre SA, et al. Diagnostic and clinical implications of anorectal lymphogranuloma venereum in men who have sex with men: a retrospective case-control study. Clin Infect Dis. 2006 Jan 15;42(2):186-94.Texto completo  Resumen

Stamm WE. Lymphogranuloma venereum. In: Holmes KK, Sparling PF, Stamm WE, et al., eds. Sexually transmitted diseases. 4th ed. New York, NY: McGraw Hill; 2007:595-606.

Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep. 2021 Jul 23;70(4):1-187.Texto completo  Resumen

Mabey D, Peeling RW. Lymphogranuloma venereum. Sex Transm Infect. 2002 Apr;78(2):90-2.Texto completo  Resumen

Thorsteinsson SB. Lymphogranuloma venereum: review of clinical manifestations, epidemiology, diagnosis, and treatment. Scand J Infect Dis Suppl. 1982;32:127-31. Resumen

Annamuthodo H. Rectal lymphogranuloma venereum in Jamaica. Ann R Coll Surg Engl. 1961 Sep;29:141-59.Texto completo  Resumen

Artículos de referencia

Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
  • Lymphogranuloma venereum images
  • Diferenciales

    • Syphilis (Treponema pallidum)
    • Gonococcal proctitis
    • Genital herpes (HSV)
    Más Diferenciales
  • Guías de práctica clínica

    • BASHH summary guidance on testing for sexually transmitted infections, 2023
    • Sexually transmitted infections treatment guidelines, 2021
    Más Guías de práctica clínica
  • Folletos para el paciente

    Chlamydia

    Más Folletos para el paciente
  • padlock-lockedInicie sesión o suscríbase para acceder a todo el BMJ Best Practice

El uso de este contenido está sujeto a nuestra cláusula de exención de responsabilidad