Lymphogranuloma venereum

性病性淋巴肉芽肿

Evidence-backed information EN 5/7 applicable sections · ZH 5/7 applicable sections Updated Oct 23, 2026

Lymphogranuloma venereum is a sexually transmitted infection produced by invasive L1–L3 serovars of Chlamydia trachomatis, distinct from the milder A–K serovars ^[1]. Formerly rare in industrialized settings, it has re-emerged notably among men who have sex with men, while remaining endemic in parts of Africa, Asia, South America, and the Caribbean ^[1]^[2]^[3]. It can involve genital, colorectal, or lymphatic manifestations and warrants evaluation for co-occurring sexually transmitted infections ^[1]^[2].

Read the full clinical and epidemiological profile 6

Definition

LGV is a sexually transmitted infection caused by the invasive L1, L2, or L3 strains of Chlamydia trachomatis, producing more severe inflammatory and invasive disease than the A–K serovars that typically cause mild or asymptomatic infection ^[1]. It is recognized as a distinct sexually transmitted disease entity within the strict sense of STIs ^[4]^[2].

Clinical features

LGV may present with genital or colorectal syndromes, lymphadenopathy, or proctocolitis ^[1]. Rectal involvement, most often following exposure among men who have sex with men or women, can mimic inflammatory bowel disease with mucoid or hemorrhagic discharge, anal pain, constipation, fever, or tenesmus, though it may also be asymptomatic ^[1]. Among heterosexual persons, a frequent manifestation is tender inguinal or femoral lymphadenopathy ^[1].

Epidemiology

LGV was originally endemic in tropical regions and transmitted mainly through heterosexual contact, but since the early 2000s it has spread in industrialized countries principally among men who have sex with men, often causing severe proctitis ^[2]. Outbreaks of LGV proctocolitis have been reported in this group, which has high rates of HIV infection ^[1]. The infection remains rare in industrialized countries but is endemic in parts of Africa, Asia, South America, and the Caribbean ^[3]. The first case in the Czech Republic was identified in 2011 ^[2].

Transmission

LGV is transmitted through sexual contact, with the term encompassing close physical contact to all variants of sexual behavior ^[4]. Rectal exposure among men who have sex with men or women can result in proctocolitis, whereas heterosexual contact has historically been the predominant route in endemic tropical settings ^[1]^[2].

Prevention

Prompt evaluation, recommended treatment, and follow-up testing help limit ongoing transmission and complications ^[1]. Recent sex partners should be evaluated and presumptively treated, and patients are advised to avoid sexual activity until treatment is completed and symptoms have resolved ^[1]. Diagnosis of LGV should also prompt testing for other sexually transmitted infections ^[1].

References

1 US Centers for Disease Control and Prevention. Lymphogranuloma Venereum (LGV) - STI Treatment Guidelines [Internet]. cited 23 Oct 2026. Available from: https://www.cdc.gov/std/treatment-guidelines/lgv.htm
2 Vaňousová D et al. [Lymphogranuloma venereum]. Cas Lek Cesk. 2012. PMID: 23301587. PubMed: https://pubmed.ncbi.nlm.nih.gov/23301587/
3 Mabey D et al. Lymphogranuloma venereum. Sex Transm Infect. 2002 Apr. PMID: 12081191. doi: 10.1136/sti.78.2.90. PubMed: https://pubmed.ncbi.nlm.nih.gov/12081191/
4 Fuchs W et al. Sexually transmitted infections. J Dtsch Dermatol Ges. 2014 Jun. PMID: 24889293. doi: 10.1111/ddg.12310. PubMed: https://pubmed.ncbi.nlm.nih.gov/24889293/
5 Smith EP et al. Chlamydia trachomatis: a model for intracellular bacterial parasitism. J Bacteriol. 2025 Mar 20. PMID: 39976429. doi: 10.1128/jb.00361-24. PubMed: https://pubmed.ncbi.nlm.nih.gov/39976429/