Last reviewed: 30 Sep 2024
Last updated: 12 Aug 2022
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 tests
1st tests 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
Tests 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.
Peer reviewers
Cees van Nieuwkoop, MD
Department of General Internal Medicine
Leiden University Medical Centre
Leiden
The Netherlands
Disclosures
CvN declares that he has no competing interests.
David Chelmow, MD
Chair
Department of Obstetrics and Gynecology
Virginia Commonwealth University
Richmond
VA
Disclosures
DC declares that he has no competing interests.
Differentials
- Syphilis (Treponema pallidum)
- Gonococcal proctitis
- Genital herpes (HSV)
More DifferentialsGuidelines
- Sexually transmitted infections treatment guidelines, 2021
- 2019 European guideline on the management of lymphogranuloma venereum
More GuidelinesPatient information
Chlamydia
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