From the FDA Drug Label
Lymphogranuloma venereum caused by Chlamydia trachomatis.
- Yes, Lymphogranuloma Venereum (LGV) is caused by Chlamydia trachomatis 1.
From the Research
Yes, Lymphogranuloma Venereum (LGV) is caused by specific invasive serovars (L1, L2, and L3) of Chlamydia trachomatis. LGV is a sexually transmitted infection that differs from typical chlamydial infections because it invades the lymphatic system rather than remaining localized to mucosal surfaces. The infection typically progresses through three stages: first, a painless genital ulcer that often goes unnoticed; second, painful inflammation of lymph nodes (buboes) in the groin; and third, if untreated, potential complications including rectal strictures, fistulas, or genital elephantiasis.
Key Points
- The recommended treatment for LGV is doxycycline 100mg twice daily for 21 days, which is a longer duration than for standard chlamydial infections 2.
- Alternative regimens include erythromycin 500mg four times daily for 21 days if doxycycline is contraindicated.
- Testing involves nucleic acid amplification tests (NAATs) for C. trachomatis, with additional genotyping to identify the LGV serovars.
- LGV has become increasingly common among men who have sex with men, particularly in association with HIV and other sexually transmitted infections 3, 4, 5.
- Recent studies have shown that azithromycin can be an effective alternative treatment for LGV proctitis, with a high cure rate and minimal side effects 2.
Diagnosis and Treatment
LGV diagnosis is often delayed due to its non-specific symptoms, and it is essential to consider LGV in the differential diagnosis of patients with persistent rectal symptoms, especially among men who have sex with men (MSM) and those living with HIV 3, 4, 5.
Prevention
Prevention of LGV involves safe sex practices, including the use of condoms, and regular screening for sexually transmitted infections among high-risk populations.
Recent Findings
A recent study published in 2021 found that azithromycin is an effective treatment for LGV proctitis, with a cure rate of 98% 2. This study provides new evidence for the treatment of LGV and highlights the importance of considering alternative treatment options for patients who may not respond to traditional treatments.