Lymphogranuloma venereum (LGV) is a sexually transmissible infection (STI). It is caused by bacteria called Chlamydia trachomatis. Some types of this bacteria cause the genital infection chlamydia. Other types of this bacteria cause LGV. Chlamydia and LGV are quite different infections. LGV causes ulcers or sores of the genital area and then invades the lymph glands in the pelvis and groin.
LGV is common in South and Central America, the Caribbean, Southeast Asia and Africa. The infection has also spread to Europe, North America and Australia, where it is often diagnosed in men who have sex with men (MSM). In Australia, LGV is rare and occurs mainly in MSM and in people who have travelled or lived in countries where it is common.
After exposure to the infection, a small ulcer or sore develops but may not be noticed. This can be on the penis in men, in the vagina or around the outside of the vagina (vulva) in women, or on the anus. In men and women who have anal sex, this ulcer or sore can occur in the rectum (back passage). This ulcer or sore can heal without treatment, but the infection has not gone away.
Between two and six weeks after initial infection, the lymph glands in the groin or inside the pelvis will begin to show signs of infection, becoming very swollen and painful. The infected person may become unwell with fevers, aching muscles and joints, and headaches.
In anal infections a person may experience pain, discharge, bleeding, constipation and/or inflammation. The infection can spread to tissues around the lymph glands. In the groin, this can cause large sores which break out on the skin. Inside the pelvis, this can involve the vagina, the rectum and the bowel.
Blood tests and swabs from the infected ulcers or glands are used to test for LGV. These tests and others may also be used to test for other causes or infections.
LGV is treated with antibiotics that need to be taken for at least three weeks.
To ensure the infection has been cured it is important to take all the tablets and that you do not have sex until you have finished treatment. You also need to return to your doctor or clinic for a follow-up appointment.
If you have LGV, anyone you have had sex with in the past few months will need to be tested. This is to make sure that they do not have the infection and to prevent you being re-infected. If you feel uncomfortable or embarrassed about telling your partner or partners, a member of your health care team can assist by contacting them for you. Your name is not mentioned to ensure it is a confidential process.
Alternatively, online tools and services that assist with telling partners in a confidential and, if desired, anonymous way are available:
Advising sexual partners of their exposure is essential for their health and the health of any other people they may have had sex with.
LGV is spread through unprotected vaginal, anal or oral sexual contact, especially if there is damage to the skin or mucous membranes. It can also be spread by sharing sex toys between partners. In Europe and North America, LGV has been increasingly diagnosed in MSM, and especially amongst men who have anonymous sex with multiple partners, practice ‘fisting’, practice rough sex, or share sex toys. Many of these men also have HIV, other STIs and hepatitis C.
Practise safe sex. Using a condom or dam correctly for vaginal, anal or oral sex can significantly reduce the risk of transmission of LGV and other STIs. It is important to use a new condom with each sexual partner, especially in group sex situations, and not share sex toys unless they are washed and protected with a condom. Using water-based lubricant with condoms is recommended.
You should not have sex with someone who has a visible genital ulcer or sore, or been diagnosed with LGV, until after they have completed treatment. Genital ulcers or sores could also be due to other STIs such as herpes or syphilis. If your sexual partner, or intended sexual partner, has a genital sore or ulcer, advise that person to have a sexual health check. If you have LGV, you should tell your sexual partner. They may also have the infection and this allows them to get tested and treated.
If you are planning to visit or live in a developing country, find out about diseases that occur there and how they are best avoided.
If not treated, the infection persists. It causes progressive destruction of lymph glands and tissues near lymph glands. Painful swollen lymph nodes may need to be drained using a needle. Sometimes surgery is required in the later stages of the disease. Infections that cause ulcers and sores around the genitals increase the risk of being infected with HIV if you are HIV negative and have unprotected sex with someone who is HIV positive, or of passing on HIV if you are HIV positive and have unprotected sex.