Lymphogranuloma venereum (LGV)
What is LGV ?
Lymphogranuloma venereum is a highly contagious sexually transmitted infection caused by bacteria. This infection originated in tropical climates, and is endemic in Central and South America, some regions of Africa and the Caribbean. In 2003, LGV first surfaced in gay communities in developing countries. (The first reported case appeared in Montreal in January 2004).
How do you get LGV ?
- From anal, oral and vaginal sexual relations with an infected person;
- Inserting fingers or the fist into the anus (fisting);
- Using unclean or unsanitary sex toys (dildo, butt-plug, anal enema, etc.) Sex toys should never be shared;
- From sexual relations with several partners without using a new condom or glove for each partner.
What are the symptoms of LGV ?
Lymphogranuloma venereum (LGV) is a bacterial infection that causes sores on the penis, vagina and vulva, and occasionally in the cervix and anus. These sores may serve as entry points for other sexually transmitted infections (STI), such as HIV, Hepatitis A, B and C, and other blood-borne infections.
First stage (Primary LGV)
A small painless sore (shallow ulcer or lump) may appear 3 to 30 days after sexual contact, in the area where the LGV bacteria first entered the body (mouth, urethra or glans penis). It can often go unnoticed, unless it is in the urethra, whereupon the infection can cause a burning sensation during urination. In the first stage, symptoms may disappear and go unnoticed.
Second stage (Secondary LGV)
Between 2 and 6 weeks after initial contact with the germ, you may develop an infection in your lymph nodes (often in the groin) causing pain and fever. Fewer than one patient in three may develop abscesses, fistulas and pus-filled discharge. You may also experience headaches. A period of general malaise (fever, chills, fatigue, loss of appetite, muscle and joint pain) may also occur.
Third stage (Tertiary LGV)
Untreated LGV is a serious infection which can cause severe health problems. Excrescences or hemorrhoid-like growths may appear around the anus. The genitals may also become infected, and emergency surgery may be necessary to remove abscesses. In person with vagina, the third stage results in scarring and permanent damage to the genital area.
What is the treatment for LGV ?
LGV is treated by taking prescribed antibiotics. Until the second stage, LGV is easily treated with 21 days of antibiotic, and leaves no sequelae. This treatment does not protect against further contamination. In the third stage, surgery may be necessary, followed by 4 to 6 weeks of antibiotics. Subsequent repair surgery may be required. If you have been infected with LGV, it is important to inform all your sexual partners of the last 60 days so that they can receive treatment to limit the progression of the disease.
Additional information
Reporting of LGV has recently become compulsory in Quebec.* Therefore, doctors who diagnose LGV must inform the Public Health Department of their region.
A public health professional will offer support in identifying and informing sexual partners up to 6 weeks prior to the appearance of the first symptoms. If the person with gonorrhea is asymptomatic, sexual partners from even earlier must also be informed.