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Lymphogranuloma venereum - Anogenital in
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Lymphogranuloma venereum - Anogenital in

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Contributors: Lowell A. Goldsmith MD, MPH, Benjamin K. Fisher MD
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Synopsis

Lymphogranuloma venereum (LGV) is an uncommon sexually transmitted disease caused by the obligate intracellular bacteria Chlamydia trachomatis (types L1, L2, L3). Chlamydia trachomatis is the only Chlamydia capable of causing systemic infection. The organism cannot penetrate intact skin or mucosal membranes, thus a break in the skin or mucosa is needed for infection.

There are 3 distinct stages in the course of the disease.

Stage one:
After a 3–30 day incubation period, a small, painless papule or pustule develops on the genital area. Most often it will erode and ulcerate. This lesion is often asymptomatic and heals without scarring within one week. Some patients may be unaware of this occurrence.

Stage two:
The second or inguinal stage begins 2–6 weeks after the primary lesion. It signifies the spread of the organism from the primary lesion into the lymph nodes and presents as inguinal buboes (painful inflammation of the inguinal lymph nodes), which become fluctuant and rupture. Symptoms include general weakness, headache, and weight loss. It is usually during this stage that patients seek medical help.

Stage three:
The third stage of LGV is elephantiasis of the penis and scrotum. This swelling is caused by fibrosis with occlusion of the lymphatics, which impedes lymphatic return. Genitoanorectal syndrome can also be seen in the third stage, but usually only in men who have sex with men or in women. These patients initially present with proctocolitis, followed by perirectal abscesses, strictures, fistulas, and rectal stenosis.

Codes

ICD10CM:
A55 – Chlamydial lymphogranuloma (venereum)

SNOMEDCT:
186946009 – Lymphogranuloma Venereum

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Last Updated: 10/24/2014
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Lymphogranuloma venereum - Anogenital in
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Lymphogranuloma venereum (Stage One (Male)) : Pustule, Skin ulcer, Smooth papule, Inguinal region
Clinical image of Lymphogranuloma venereum
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