(lim-foj′ĕ-nŭs) [lympho- + -genous] 1. Forming lymph. 2. Derived from lymph.
(lĭm″fō-grăn-ū-lō″mă-tō′sĭs) [″ + granulum, granule, + Gr. oma, tumor, + osis, condition] 1. Infectious granuloma of the lymphatics. 2. Hodgkin’s disease.
(lim″fō-gran″yŭ-lō′mă vĭ-nir′ē-ŭm) [L. venereus, pert. to Venus] ABBR: LGV. A sexually transmitted cause of genital ulcer disease and proctitis. SYN: lymphogranuloma inguinale; lymphopathia venereum. SEE: pelvic inflammatory disease; sexually transmitted disease.
INCIDENCE: LGV infections are reported in about 300 people a year in the U.S. The disease is more common in those infected with HIV and in men who have sex with other men.
CAUSES: LGV is caused by Chlamydia trachomatis.
SYMPTOMS AND SIGNS: Infection can cause a painless red erosion on the genitals or rectum, followed approx. 1 to 2 weeks later by buboes (enlargements of the inguinal lymph node). Buboes may obstruct lymphatic channels or cause fistulous tracts to neighboring tissues if the infection is not treated. However, because many men and more women do not recognize early symptoms, the disease may spread from person-to-person and proliferate inside the infected individual, with severe consequences. Symptomatic patients may develop ulcerating vesicles on the genitals, urethral inflammation, abdominal pain, and swollen lymph nodes in the groin and rectum; men often have inflamed and swollen testicles. Approx. 40% of women develop chronic pelvic inflammatory disease (PID), leading to chronic pain, infertility, and an increased risk of having a tubal pregnancy. Spread of the disease into perirectal lymph nodes may cause scarring and rectal obstruction.
DIAGNOSIS: The CDC recommends that all sexually active women under 20 years old be screened yearly for chlamydia; sexually active women over the age of 20 with multiple sex partners who do not use condoms should also be screened yearly. Swabs taken from genital tissues (or from genital ulcers) are sent for nucleic acid amplification testing, immunofluorescence, or microbiologic cultures, although the latter are relatively insensitive.
PREVENTION: Safe sexual practices prevent infection with LGV.
TREATMENT: The disease can be treated effectively with a 3-week course of doxycycline or azithromycin; erythromycin is used for pregnant women. Recurrent infection is common if barrier contraception is not used during intercourse.
PATIENT CARE: Infected patients should be educated about the importance of completing the full course of prescribed antibiotic therapy to prevent long-term complications of infection, such as lymphatic obstruction in the legs, or chronic scarring of the fallopian tubes, anus, or rectum. Sexual partners of infected patients should be contacted and screened for infection to prevent further outbreaks. Patient education about potential side effects of the illness and its treatment regimens is crucial, as is education about safe sexual ...