Women’s Health

Lymphogranuloma Venerum (LGV)

LGV is a relatively rare sexually transmitted disease that affects lymph notes and is caused by serovars L1, L2, and L3 of the bacterium Chlamyida trachomatis. The infection produces a painless ulcer and may be confused with primary syphilis. The disease is rare in the U.S. with fewer than 600 cases reported annually–far fewer cases are reported in women than in men. LGVis endemic in parts of Africa, India, Southeast Asia, South America and the Caribbean. Recent outbreaks have occurred in Europe

The primary stage of the disease starts out as a painless ulcer at the site where the bacteria gain entrance to the mucous membrane or skin. Typically, in women the initial site of entry is the vaginal wall. The ulcer lasts 3-12 days. While men can easily detect their lesions it often goes unnoticed in women because it is painless and out of site. The lesion heals before the disease enters the secondary stage some 10 – 30 days later.

LGV gains entrance through breaks in the skin and travels through lymphatic channels settling into lymph nodes where it causes the formation of abscesses – also called buboes. If the affected lymph nodes are in the groin it causes the inguinal syndrome. These same abscesses occur in the lymph nodes draining the rectum the rectal syndrome of this disease appears.

The secondary stage is characterized by the spread of the infection to the surrounding lymph nodes along the lymphatic drainage pathways. In women the infection may spread to the cervix (cervicitis), the internal tissues alongside the uterus (perimetritis) or the fallopian tubes (salpingitis). In addition the deep lymph nodes may become infected causing lymphadenitis. About 20% of women will develop a swelling and abscess in their inguinal lymph nodes. This is often accompanied by fever, chills, fatigue and loss of appetite.

If left untreated a tertiary stage follows characterized by permanent scarring may occur in various internal organs leading to infertility, pelvic pain and others symptoms resulting from permanent scarring.