Venereal lymphogranuloma (LGV): What it is, symptoms and treatment


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Venereal lymphogranuloma, also called mule or LGV, is a sexually transmitted infection that is caused by three different types of the bacterium Chlamydia trachomatis, which are also responsible for causing chlamydia. When the bacterium reaches the genital region, it leads to the formation of painless wounds that are filled with fluid and may not easily be perceived.

LGV is transmitted through unprotected sexual intercourse and for this reason it is important to use a condom when having sex, and also ensure that you keep the genital region hygienic after sexual intercourse. Treatment is usually done using antibiotics, which should only be prescribed by a doctor depending on the sensitivity profile of the microorganisms and the symptoms presented by the individual. The prescribed drugs are usually Doxycycline or Azithromycin.

Main symptoms

The incubation period of chlamydia trachomatis is about 3 to 30 days. That is, the first symptoms of infection begin to appear up to 30 days after exposure and contact with the bacterium. In general, this disease can be classified into three stages according to the severity of the symptoms experienced.

  • Primary stage: The symptoms begin to arise between 3 days to 3 weeks after contact with the bacterium. The first symptom is usually a small blister in the genital region, which shows the point of entry of the bacterium. In addition, there may also be a slight swelling in the groin which is a sign that the bacteria has reached the ganglia site. In case the transmission was through anal sexual intercourse, there may be pain in the retract, discharge and constipation. Most infected women are usually asymptomatic and the disease will only be discovered when it is in the preceding stages.
  • Secondary stage: In this stage, the symptoms arise between 10 and 30 days after contact with the bacterium. It is characterized by the most noticeable swelling in the groin. There may also be swelling of the ganglia in the armpits or neck, fever and redness in the region as well as ulcers, bleeding and mucous outflow, if the infection was through anal sex.
  • Tertiary stage: It occurs when the disease has not been properly identified and/or treated. It leads to worsening of the inflammation of the ganglia and the genital region as well as the appearance of ulcers, which will favour secondary infections.
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If the symptoms are not identified and the disease is treated quickly or in the correct manner, other complications may arise such as penile and scrotal lymphedema, intestinal hyperplasia, vulvar hypertrophy and proctitis, which is the inflammation of the mucosa that lines the rectum and this will happen if the bacterium was acquired through anal sex.

Venereal lymphogranuloma can be acquired through sexual intercourse without using a condom and it is therefore considered a sexually transmitted infection. Diagnosis is made by analysis of the symptoms presented and blood tests which will identify antibodies against Chlamydia trachomatis, as well as the wound secretion culture, which can be useful in identifying the microorganism and prescribing the best antibiotic for treatment.

How treatment is done

Treatment should be done according to a medical prescription and antibiotics are usually recommended. The main drugs that are usually prescribed include:

  • Doxycycline for 14 to 21 days
  • Erythromycin for 21 days
  • Sulfamethoxazole/ trimethoprim for 21 days
  • Azithromycin for 7 days

The antibiotic and treatment time should be indicated by the doctor depending on the sensitivity profile of the microorganism and the symptoms presented. In addition, it is also important that the person has regular tests to ensure that the treatment is taking effect. The partner should also be examined and treatment even if they do not present any symptoms.

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Cornelius A.

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