How long does it take for a lymphogranuloma venereum (LGV) to resolve with proper treatment?

Treatment and Resolution Time for Lymphogranuloma Venereum (LGV)

Azithromycin 1g daily for two weeks is not the recommended treatment for LGV, and you should switch to doxycycline 100mg twice daily for 21 days for complete resolution of the lymphogranuloma. 1

Proper Treatment for LGV

• Doxycycline 100mg orally twice daily for 21 days is the preferred and recommended treatment regimen for LGV 1
• Alternative treatment for those who cannot take doxycycline (such as pregnant women):
  • Erythromycin base 500mg orally four times daily for 21 days 1
• Some specialists believe azithromycin 1g orally once weekly for 3 weeks may be effective, but clinical data supporting this regimen is limited 1
• Your current regimen of azithromycin 1g daily for two weeks is not a standard treatment protocol for LGV 1

Expected Resolution Timeline

• Patients with LGV should be followed clinically until signs and symptoms have completely resolved 1
• Complete resolution typically requires the full 21-day course of appropriate antibiotic therapy 1
• Tissue reaction from LGV can result in scarring even after the infection is cured 1
• Some recent research suggests that shorter courses (7-14 days) of doxycycline may be effective in some cases, but the standard recommendation remains 21 days 2

Important Considerations

• Both you and your partner should:
  • Complete the full course of appropriate antibiotic therapy (doxycycline for 21 days) 1
  • Abstain from sexual contact until treatment is completed and symptoms have resolved 1
  • Receive testing for other STIs including HIV, as co-infections are common 1, 3
• For vaginal LGV lesions specifically:
  • Resolution may take several weeks even with appropriate treatment 3
  • Follow-up should continue until complete resolution of the lesion 1

Common Pitfalls and Caveats

• Inadequate treatment duration is a common pitfall in LGV management 3, 4
• Approximately 25% of anorectal LGV infections can be asymptomatic, but still require full treatment 4
• Tissue damage can continue if adequate treatment is not initiated promptly 3
• LGV can cause potentially severe infections with irreversible sequelae if not properly treated 3
• HIV-positive patients may experience delayed resolution of symptoms and may require prolonged therapy 1

For your specific case, switch to the recommended doxycycline regimen and continue treatment for the full 21 days, after which the lymphogranuloma should gradually resolve. Complete resolution may take several weeks even after completing appropriate antibiotic therapy 1, 3.